Novantrone (mitoxantrone) iyo Tysabri (natalizumab) ayaa labadaba loo isticmaalaa duruufaha la midka ah ee lagu daaweeyo cudurka multiple sclerosis - oo loogu talagalay dadka qaba xanuunka murqaha badan ee loo yaqaan 'sclerosis multiple sclerosis (RRMS) ama' progressive sclerosis '(PRMS). Novantrone waxaa loo yaqaan 'sclerosis multiple sclerosis' (SPMS), iyo Tysabri ayaa laga yaabaa in ay ka caawiso xaaladaha SPMS halkaasoo ficil-celinta firfircooni ay weli muujinayaan MRI, sidoo kale.
Midna midna maaha MS ee horukaca ah.
Tani macnaheedu waa dad badan oo qaba mid ka mid ah noocyada MS waxay leeyihiin doorasho ah inay sameeyaan: Tysabri ama Novantrone. In kasta oo ay noqon laheyd mid weyn haddii mid ka mid ah faa'iido badan oo faa'iido leh ee dhinaca kale ee dhinacyada oo dhan, tani ma aha kiiska. Sida wax kasta oo kale ee MS la eg yahay, Tysabri iyo go'aanka Novantrone waxay ku saleysan tahay farabadan xaalado adag. Doorashadu wuxuu u baahan yahay inuu ku saleysnaado doorbid shakhsiyeed iyo qaab nololeed, talo bixin dhakhtar iyo helitaan, iyo arrimo kale sida qiimaha, cabsida waxyeelooyinka gaarka ah iyo shuruudaha dabagalka.
Maqaalkani, waxaan ku dadaalay inaan isbarbardhigo Tysabri ilaa Novantrone dhinaca dhinacyada daaweynta ee aan ogahay in dadku aad u xiiseynayaan. U sheeg in daawooyinkaas mid waliba ay leedahay farsamo gebi ahaanba kala duwan , sidaa daraadeed ma aha sida daroogada ay shaqadeeda "si ka fiican" u shaqeyneyso - waxay sameeyaan waxyaabo kala duwan, laakiin hadafka la midka ah ee yaraynta horumarka naafada iyo ka hortagga MS.
Tysabri waa unug monokloral ah oo ka hortagaya qaar ka mid ah unugyada T-da oo ka soo gudbaya bararka dhiigga-maskaxda, halka Novantrone uu kiimiko ku jiro kaas oo xakameynaya firfircoonida difaaca.
Halkan waxaa ku qoran waxyaabo ay tahay inaad tixgeliso markaad sameysid doorashooyinkaaga:
Helitaanka Dhakhtarkaaga iyo Khibradaada
Dhakhaatiirta ka diiwaan gashan barnaamijka kormeerka ee TOUCH waxay qori karaan Tysabri.
Dad badan oo takhaatiirta aysan haysanin Tysabri waxay ku xiran tahay inay u beddelaan dhakhtarka neerfaha ee helaya. Si kastaba ha ahaatee dhakhtarku wuxuu qori karaa Novantrone, si kastaba ha ahaatee, waxaa lagu talinayaa in uu maamulo dhakhtar khibrad u leh kormeerka iyo daryeelidda bukaanada qaadaya daweynta kiimikada dabiiciga ah.
Saameynta iyo Ammaanka
Inkasta oo qiyaasaha khatarta ah ee labaduba Tysabri iyo Novantrone ay gebi ahaanba kala duwan yihiin, labaduba waxay keenaan jawaab-celin bilow ah ama cabsi badan dad badan - Tysabri waxay leedahay taariikhda PML iyo Novantrone waa kiimiko. Halkan waxaa ah nooca loo yaqaan "Novantrone" waxay u badan tahay in aad dareentid nuuc ycky ka dib faleebo dhowr maalmood, oo leh waxyaabo matagaya / lallabo, khatarta kaadiheysta ee kaadiheysta iyo caabuqa neef-mareenka, iyo, si fiican, waxaad lumin kartaa qaar ka mid ah timahaaga. On Tysabri, waxaa laga yaabaa inaadan dareemaynin sida guud ahaanba guud ahaan maalmaha ka dambeeya soo galinta, sida saameynaha ugu badan ee daaweyntu ay yihiin ficil-celin-bogsiin, daal, madax xanuun iyo xanuunka wadnaha. Qodobka go'aan qaadashada ee dad badan ayaa laga yaabaa inay u soo degaan si ay u kala doortaan (1.2kiiba 10,000) khatarta PML ee Tysabri oo ka soo horjeeda halista leetemia (7.4 halkii 1,000) ama dhaawaca wadnaha Novantrone.
Joogitaanka
Tysabri waxaa loo maamulaa xididada (IV ee xaruunta faleebo ama xafiiska dhakhtarkaaga) bishiiba mar.
Novantrone waxaa loo maamulaa 3 bilood oo kasta.
Isticmaalka Muddada-dheer
Tysabri (waqtigan xaadirka ah) waxaa loo isticmaali karaa si aan qarsoodi lahayn, inkasta oo ammaanka daroogada 2 sano ka dib isticmaalka aan la aqoon. Novantrone, dhinaca kale, waxaa loo isticmaali karaa oo kaliya ilaa laba illaa saddex sano (10 ama 11 qiyaasta qiyaasta) ee nolosha bukaanka.
Waxtarka
Waxtarka daawooyinka ayaa u muuqda mid la mid ah, laakiin way adag tahay in la isbarbardhigo, sababtuna tahay kala duwanaanta naqshadaynta daraasadda. Daraasad 2 sano ah, marka la barbardhigo placebo, Novantrone ayaa lagu muujiyay in ay yareeyso tirada soo noqoshada , waqtiga dheeraadka ah ee u dhexeeya dib u soo noqoshada, waxay muujineysaa in 61% hoos u dhac ku yimaado ka-qayb-galka ka-qaybgalayaasha ee karti-u-socodka iyo naafonimo aad u yar.
Tysabri ayaa muujisay hoos u dhac 68% ah dib-u-soo-kabashada laba sano, iyo sidoo kale hoos u dhigidda horumarka naafada iyo yaraynta tirada soo noqoshada cusub.
Uurka (hadda iyo mustaqbalka) iyo Naasnuujinta
Dumarka uurka leh ama isku dayaya inay uur qaadaan waa in aysan qaadanin Tysabri ama Novantrone, mana isticmaali karaan dumarka naas-nuujinaya. Tysabri waxaa loo tixgeliyaa inay tahay "qaybta uurka," taasoo macnaheedu yahay in ay waxyeelo u geysatay ilmaha uurjiifka ah ee daraasaadka xayawaanka laakiin saameynta bani-aadamka lama garanayo. Tysabri waa in la joojiyaa wakhti ka hor inta aanad isku dayin inaad uur yeelatid (sida caadiga ah hal ilaa seddex bilood, kala hadal dhakhtarkaaga). Novantrone waxaa loo tixgeliyaa inay tahay "qaybta uurka" Qaybta D, "taasoo macnaheedu yahay inay u keeni karto waxyeellada uurjiifka marka haween uur leh la siiyo. Dumarka dhalida da'da ah waxay ubaahantahay baaritaano uur ka hor inta aaney qaadan qiyaas kasta oo Novantrone ah.
XUSUUS MUHIIM AH: Haweenka qaarkood (5-30%) oo buuxiya koorso buuxda oo Novantrone ah marnaba marxaladoodii mar kale way bilaabaan oo waxay nadiif yihiin (aan awoodin inay uuraystaan). Aad bay muhiim u tahay inaad tixgeliso suurtogalnimada suurtagalnimada markaad go'aansato inaad isticmaalayso Novantrone iyo inaad kala hadasho ninkeeda ama lammaanahaaga. Daraasadihii ugu dambeeyay waxay muujinayaan in fursadda macaamilka haweenku hoos u dhigi karto isticmaalka daaweynta hoormoonka (daaweynta estroprogestinic) inta lagu jiro daaweynta Novantrone tanina waa in lagala hadlo dhakhtarkaaga.
Solu-Medrol
Solu-Medrol, corticosteroid intravenous oo loo isticmaalo in la gooyo muddada iyo mudnaanta soo noqoshada, guud ahaan laguma taliyo dadka isticmaala Tysabri ugu yaraan hal bil kahor ama ka dib markii ay soo noqnoqonayeen, sababtoo ah difaaca jirka ee kordhaya, inkastoo ay jiraan qaar Dhakhaatiirta ayaa u qori doona kiiska soo noqoshada waxaanan maqlayey qiyaaso dhexdhexaad ah (125 illaa 500 mg) oo isla mar la siiyey infekshanka Tysabri si looga caawiyo dareen-celinta xasaasiyadda yaryar ee Tysabri. Dhinaca kale, Solu-Medrol waxaa badanaa la siiyaa waqti isku mid ah fayruuska Novantrone waxaana si xor ah loo siin karaa marka uu dhaco dib u dhac ku yimaada infakshanka Novantrone.
Kormeerka
Ka hor inta aanad bilaabin Novantrone, waxaad qaadan doontaa baaritaanada soo socda: baaritaanka dhiiga (CBC, shaqada beerka, uurka haweenka), elektrokardiogram (EKG), iyo echocardiogram sida qiimeyn asaasi ah ee loo yaqaan 'EGGEF' waa in la sameeyaa ka hor qiyaas kasta ee Novantrone. Daaweynta Novantrone waa in la joojiyaa haddii LVEF uu si weyn u badalo ama waligiis ka yar 50%. Dhamaan tijaabooyinka waxaa lagu celin doonaa daaweyn kasta. Tysabri waxaa kaliya lagu bixin karaa xarun faleebo oo lagu diiwaangeliyo barnaamijka "TOUCH". "TOUCH" wuxuu u taagan yahay "Tysabri Outreach: Ballanqaadka Midaysan ee Caafimaad" waana barnaamijka lagu meeleeyay isku daygii lagu soo afjari lahaa xaalado kasta oo suurogal ah PML marxaladaha hore, iyo sidoo kale ka hortagga. Waxaa lagugu baadhi doonaa dhakhtar ama kalkaaliye caafimaad oo aad ka qaadatid MRI ka hor intaadan bilaabin Tysabri, ka dibna waxaa lagaa baarayaa 3 ilaa 6 bilood oo isbeddel ku yimaada neerfaha. Waxaa lagu weydiin doonaa inaad dib u eegto macluumaadka badbaadada bukaanka isla markaana buuxi sahan gaaban ka hor intaanad galin.
Khilaafaadka
Novantrone waa in aan loo isticmaalin dadka qaba cudurka wadnaha ama qaadashada daawooyin kale oo dhaawici kara wadnaha, dhibaatooyinka beerka, dhiigga cas oo yar iyo caddaan ah, dhibaatooyinka xinjirta dhiigga, kansarka ama taariikhda daaweynta kansarka ee hore. Tysabri waa in aan lagu qaadin dadka qaata tallaal-difaac ama difaaca jidhka ama dadka leh nidaamyada difaaca jirka. Maandooriyuhu waa in ay qaataan dadka qaba caabuqyada hadda jira.
Kharashka
Tysabri waa mid ka mid ah daaweynta ugu qaalisan MS, oo ah $ 28,400 sannadkii loogu talagalay Tysabri lafteeda. Qiimaha Novantrone qiyaastii $ 3,000 doolar sanadkiiba daawada, taas oo ka dhigeysa ugu yaraan qaali. Labaduba waxay ku yimaadaan kharash dheeraad ah oo loogu talagalay xarunta faleebada.
Khadka hoose
Go'aanka loo isticmaalo Tysabri ama Novantrone waa shakhsiyad gaar ah, taas oo noqon karta mid fudud ama adag, iyadoo ku xiran hadba sida aad wax u farasaarayso ama ku quseeya adiga (tusaale ahaan, qofka bixiya jeebka waxaa laga yaabaa inuu helo Novantrone wax ka badan rafcaan qaadashada, halka haweeney da 'yar oo rabta carruurta mustaqbalka inay ku tiirsan tahay Tysabri). Haddii dhakhtarkaagu uu leeyahay fikrad aad u xoogan hal dhinac ama mid kale, hubso in aad waydiiso isaga ama iyada in ay sharaxdo sababaha. Marwalba waxaad dareentaa inaad bilaash u heshid aragti kale haddii aadan weli qancin. Waxay noqon kartaa in dhakhtarkaagu aanu lahayn Tysabri - haddii aad rabto, raadso dhakhtar kale oo sameeya kana codsanaya ra'yigiisa. Taa bedelkeeda, waxay noqon kartaa in dhakhtarkaagu aanu ku raaxeysanayn isticmaalka dawooyinka kemotherabi, laakiin waxaa jira dhakhaatiir kale oo badan oo Novantrone u isticmaalay boqolaal bukaan oo leh natiijooyin fiican. Isku day inaad raadiso jawaabo ilaa aad ku qanacsan tahay.
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