Daroogada Isku-Dagaalladu waxay bixisaa Heerarka Dhiig-karka ee Genotype 1 iyo 4 Infekshannada
Qeybinta
Zepatier (elbasvir / grazoprevir) waa daroogo isku dhafan oo loo isticmaalo daaweynta infakshanka cagaarshow C (HCV) ee joogtada ah. Labada daawo ee ka kooban Zepatier (elbasvir, grazoprevir) waxay ku shaqeeyaan xakameynta labadaba borotiinka (NS5a) iyo enzym (NS3 / 4a protease) oo muhiim u ah soo-saarka fayraska.
Zepatier waxaa la ansixiyay 28-kii Juunyo 2016-ka Maamulka Maraykanka ee Cunta iyo Maandooriyaha (FDA) si loogu isticmaalo dadka waaweyn 18 sano ama ka badan HCV genotype 1 ama 4 infekshanka , oo ay ku jiraan kuwa qaba cirrhosis.
Waxaa loo ogolaaday isticmaalka labada daaweyn (daaweyn-naeef) ama hore loo daweeyey (daawayn khibrad leh) bukaanno, iyada oo ku xidhan Xeerka HCV iyo xaaladda daaweynta.
Waxtarka
Zepatier waxaa lagu soo waramayaa in ay leeyihiin heerar daaweyn oo heer sare ah oo ku jira marxaladda 2aad ee aadanaha. Daaweynta HCV waxaa lagu qeexay inay sii wadi karto culeyska fayruuska aan la ogaan karin muddo 24 toddobaad ah kadib marka la dhammeeyo daaweynta (oo loo yaqaanno jawaab celin joogta ah oo dheellitiran, ama SVR ).
Heerka guud ee SVR wuxuu u dhexeeyay 94% ilaa 97% bukaanada qaba HCV genotype 1, halka bukaanno qaba infekshanka 4-aad ee la soo wariyay ay sheegeen in ay leeyihiin heerka SVR oo ah 97% ilaa 100%.
Qiyaasta
Hal kiniin (50mg / 100mg) ayaa maalin walba la qaataa ama aan lahayn cunto. Kiniiniyada Zepatier waa nooc quruxsan, midab leh iyo filim qaboojiye leh, oo leh "770" daboolay hal dhinac.
Soo-jeedinta Talooyinka
Zepatier waxaa loo qoraa midkood ama aan lahayn ribavirin loogu talagalay cudurka genotype 1 ama 4. Si ka duwan sidii hore ee daaweynta HCV, peginterferon (daroogo la xidhiidha saameyn aan badneyn oo aan la dabooli karin) looma baahna.
Ka hor intaan la bilaabin daweynta, baaritaanka hidda-socodka ayaa la samayn karaa si loo go'aamiyo in aad leedahay nooca virus-ka oo u adkeysanaya qaybta elabvir ee Zepatier (oo loo yaqaanno NS5a-resistant-polymorphism).
Waqtiga daaweynta waxay u dhaxeysaa 12-16 asbuuc, taas oo ku xidhan HCV genotype iyo xaaladda daaweynta.
| Genotype | Xaaladda daaweynta | Qaadashada ribavirin? | Muddada |
| Genotype 1a | daaweynta-naeef aan lahayn elbasvir-adkaysi fayraska | maya | 12 toddobaad |
| daaweyn-nadiif leh elbasvir-u adkaysta fayraska | haa | 16 toddobaad | |
| horay loola dhaqmey ribavirin + peginterferon iyada oo aan lahayn fayruska elbasvir-resistant | maya | 12 toddobaad | |
| horay loola dhaqmey ribavirin + peginterferon fayruuska elbasvir-resistant | haa | 16 toddobaad | |
| horay loola dhaqmey ribavirin + peginterferon + xanuunka HCV protease inhibitor ah | haa | 12 toddobaad | |
| Genotype 1b | daaweyn-naeefan | maya | 12 toddobaad |
| horay loola dhaqmey ribavirin + peginterferon | maya | 12 toddobaad | |
| horay loola dhaqmey ribavirin + peginterferon + xanuunka HCV protease inhibitor * | haa | 12 toddobaad | |
| Genotype 4 | daaweyn-naeefan | maya | 12 toddobaad |
| horay loola dhaqmey ribavirin + peginterferon | haa | 16 toddobaad |
* - Olysio (simeprevir), Victrelis (boceprevir), Incivek (telaprevir)
Saameynada Caadiga ah
Waxyeellooyinka ugu badan ee la xiriira isticmaalka Zepatier (oo ku dhaco in ka badan 5% bukaanada) waa:
- Daal
- Madax xanuun
- Lalabbo
Marka la isticmaalo ribavirin, dhibaatooyinka daaweynta ee ugu badan ee la daaweeyey (oo ku dhaco in ka badan 5% bukaanada) waxaa ka mid ah:
- Madax xanuun
- Daal
- Anemia
- Lalabbo
- Cuncunka
- Xumad
- Neefsasho gaabis ah
- Insomnia
- Murqo xanuun
- Cunto xumada
- Qufac
- Xasillooni la'aan
- Finan
Isdhexgalka daroogada
Daawooyinka soo socda waa in aan loo isticmaalin marka qaadashada Zepatier sababtoo ah waxay keeni karaan isdhexgalada mukhaadaraadka daroogada ee muhiimka ah:
- Antibiyootiko: nafcillin
- Anticonvulsives: Dilantin (phenytoin), Tegretol (carbamazepine)
- Antifungal: Kiniinnada afka laga qaato (ketoconazole)
- Dawooyinka anti-hypertensive: Tracer (bosentan)
- Waxyaabaha dhirta laga sameeyey: Wort John Wort
- Daawooyinka HIV-ga ee loo yaqaan ' Antifungal Medicine' : Aptivus (tipranavir), Genvoya (elvitegravir, cobististat, emtricitabine, tenofovir alafenamide), Intelis (etravirine), invirase (saquinavir), Kaletra (lopinavir, ritonavir), Prezista (darunavir), Reyataz (atazanvir), Stribild elvitegravir, cobicistat, emtricitabine, tenofovir disproxil), Sustiva (efavirenz),
- Daawooyinka Immunosuppressant ee loo isticmaalo in looga hortago in diidmada xubinta taranka: cyclosporine
- Dawooyinka Rifampin-ku salaysan ee daaweynta qaaxada: Mycobutin, Priftin, Rifater, Rifamate, Rimactane, Rifadin
Tixgelinta Daaweynta
Waxaa lagu soo bandhigay daraasad kiliinik ah in 1% bukaannada ku jira Zepatier ay sameeyeen heer sare oo ah unugyada beerka beerka oo muujinaya sunta sunta ah, guud ahaan ama ka dib isbuuca siddeedaad ee daaweynta. Sidaa daraadeed, baaritaanka dhiigga ee la xidhiidha beerka ayaa loo baahan yahay in la sameeyo ka hor inta aan la bilaabin daweynta iyo si joogto ah muddada daaweynta HCV.
Zepatier waa in aan loo qorin bukaanka qaba cillad beer culus.
Isticmaalka ribavirin wuxuu uur kudoon yahay uurka waana inaan lagu qorin Zepatier ama nooc kale oo cagaarshow C ah. Dumarka haweenka ku jira daaweynta ribavirin-ku salaysan waa in lagula taliyaa in ay ka fogaadaan uurka iyo inay isticmaalaan ugu yaraan laba hab oo hormoon ah oo ka hortagga uurka inta lagu jiro muddada daaweynta iyo lix bilood ka dib dhammaystirka daaweynta.
Xigasho:
Maamulka Cuntada iyo Dawooyinka Maraykanka (FDA). "FDA waxay ansixisay Zepatier si loogu daaweeyo cudurka cagaarshow C ee jilicsan 1 iyo 4." Silver Spring, Maryland; saxaafadeed la soo saarey January 28, 2016.
Merck. "Zepatier - Warbixinaha Wargelinta". Kenilworth, New Jersey; helitaanka Janaayo 29, 2016.