Mukhaadaraadka Biyoolojiga ee aan Isku mid ahayn ee loogu talagalay Bukaanka Shaqsiga ah
TNF (tumor necrosis factor) ayaa xayiray daaweyn loogu talagalay bukaanka qaba rheumatoid arthritis-ka ama nooc kale oo xanuunka nooca "arthritis" laga bilaabo 1998-dii markii Enbrel (etanercept) uu ahaa FDA ogolaaday. Qaar ka mid ah daawooyinka nafleyda ee kale ayaa tan iyo markii la ansixiyey oo la suuq gareeyey.
Xannibaadayaasha TNF waxaa ka mid ah Enbrel (etanercept), Remicade (Infliximab), Humira (adalimumab), Simponi (golimumab) iyo Cimzia (certolizumab pegol).
Waxaa sidoo kale jira daawooyinka kale ee nafleyda, sida Orencia (abatacept), Rituxan (rituximab), Actemra (tocilizumab), iyo Kineret (anakinra) oo aan diidan TNF.
Haddii lagugu daaweynayo xannibaadaha TNF, waxaa laga yaabaa in lagama maarmaan noqoto inaad beddesho TNF kale duwan ama daroogo kale oo ku takhasusay daroogada. Sababaha ku habboon ee beddelidda waxaa ka mid noqon kara:
- Jawaabta aan macquul ahayn ee daaweynta
- Waxyeellooyinka soo foodsaara ee daaweynta
- Hoos-u-dhac ku yimid waqti-dheer
Waxaan ka codsanay cilmi-baarista rheumatologist Scott J. Zashin, MD su'aalo yar oo ku saabsan beddelidda xannibaadahaaga TNF.
- Miyay suurtagal tahay in bukaanku helo jawaabo ka wanaagsan kan TNF ka duwan ama miyay isku mid yihiin?
- Miyuu bukaanku ku noqon karaa xannibaadaha TNF kadib markii uu joojiyay?
Dr. Zashin ayaa ugu jawaabay, "Ugu yaraan 70 boqolkiiba bukaanka qaba rheumatoid arthritis oo bilaabaya mid ka mid ah xannibaadayaasha TNF waxay heli doonaan horumar weyn oo xaaladdooda ah, xittaa bukaanno badan ayaa heli doona gargaar marka daawada methotrexate (Rheumatrex, Trexall) ama DMARD kale daawada anti-rheumatic) waxaa lagu daraa xannibaadaha TNF.
Haddii bukaanku aanu ka jawaabin TNF-da bilawga ah ee 3 bilood ka dib, beddelidda qof kale wuxuu kordhin doonaa fursaddooda faa'iidada. Xaqiiqdii, xitaa haddii bukaanku aanu ka jawaabin laba ka mid ah daroogada TNF, waxa laga yaabaa inuu wali ku fiicnaado inuu isku dayo saddexaad. "
Sida xaqiiqda ah, natiijooyinka daraasaddan oo la daabacay (June June 2010 ee Rheumatology) ayaa soo gabagabeeyay in bukaanada qaba spondyloarthritis- ka ay ku fashilmeen in ay ka jawaabaan Enbrel of Remicade oo ah wakiilka ugu horreeya, ayaa ka jawaabtay Humira ka dib markii ay bedeleen, iyadoon loo eegin sababta ay u beddeleen.
Daraasad kale oo xiiso leh, oo lagu daabacay Rugaha iyo Rheumatolojiyada Xanuunka ah ee 2013, ayaa shaaca ka qaaday in bukaanno qaba spondyloarthritis ay awoodi karaan in ay sii dheeraadaan TNF-blockers marka loo eego bukaanka rheumatoid arthritis-ka, ugu horreyn sababtoo ah bukaanshada lafdhabarta ee ankylosing subgroup ee bukaanada. Iyadoo labadaba rheumatoid arthritis iyo spondyloarthritis labadaba, bukaannadu waxay awoodaan inay ku dhajiyaan Enbrel iyo Humira waqti dheer marka loo eego Remicade.
Dr. Zashin ayaa intaa ku daray, "Inta badan rheumatologists ma isticmaalaan Kineret si caadi ah loogu daaweeyo cudurka rheumatoid ee arthritis sababtoo ah waxtarkeeda hoos u dhac iyo waxay u baahan tahay in ay isku durto maalin kasta, hase yeeshee, Kineret ayaa aad ugu faa'iidaystay bukaanada la ogaaday qaab nidaamsan oo ah qaabka arthritis-ka, oo loo yaqaan ' The Stroke' . "
Sidoo kale, sida laga soo xigtay Dr. Zashin, iyada oo bukaanada joojiyay daaweynta Enbrel iyo Humira ay dib ugu noqon karaan daawada iyaga oo aan welwel lahayn, kuwa ka soo baxay Remicade mudo dheer waxay la kulmayaan falcelinta faleebo kuwaas oo noqon kara khatar.
Ilaha:
Isbedelka infalximab ama etanercept ilaa adalimumab ee bukaansho u adkaysta ama aan loo dulqaadan karin daawada spondyloarthritis: daraasad 4 sano ah. Spadaro. A. et al. Rheumatology (Oxford). Juun 2010.
http://www.ncbi.nlm.nih.gov/pubmed/20223813
Ka-badbaadinta daawada ee koowaad ee wakiilada anti-TNF ee bukaanka qaba rheumatoid arthritis iyo spondyloarthritis seronegative: falanqeynta xogta MonitorNet. Scire CA et al. Reynoloji-klinikada iyo tijaabinta. November-December 2013.
http://www.ncbi.nlm.nih.gov/pubmed/23981363
Jawaab, qayb ahaan, waxaa bixiya Scott J. Zashin, MD, kaaliyaha kiliiniga oo ka shaqeeya Jaamacadda Teknoolajiyada Iskuulka Galbeedka Caafimaadka, Qaybta Rheumatology, Dallas, Texas. Dr. Zashin ayaa sidoo kale ah dhakhtar ku jira Isbitaalada Presbyterian ee Dallas iyo Plano. Waxa uu ka mid yahay Kulliyadda Maraykanka ee Dhakhaatiirta iyo College College of Rheumatology iyo xubin ka mid ah Ururka Caafimaadka Maraykanka. Dr. Zashin waa qoraaga Arthritis Without Pain - Mucjisada Anti-TNF Blockers iyo wada-jirka qoraaga Arthritis-ka Daaweynta.