Khilaafaadka Muhiimka ee Hufnaanta, Qiimaha, iyo Maamulka
Ka-hortagga TNF (oo sidoo kale loo yaqaanno TNF-blockers) waa daroogada daroogada oo hoos u dhigta caabuqa adoo diidaya jawaab-celinta jirka. Waxaa loo isticmaalaa in lagu daaweeyo noocyo kala duwan oo ka mid ah cudurada wadnaha iyo xididada oo ay ku jiraan rheumatoid arthritis (RA) , psoriasis, psoriasis arthritis, ulcerative colitis, iyo Crohn's disease.
Saddex ka mid ah kuwa ugu caansan TNF ee loo isticmaalo in lagu daweeyo RA waa:
- Gundhig
- Humira (adalimumab)
- Qaadashada (Infliximab)
Inkasta oo dhamaan saddexda daroogadu ay joojiyaan jawaabta jirka ee ku saabsan cilladda tumo necrosis (TNF) -a nooca protein, oo loo yaqaan ' cytokine' . taasoo kicinaysa barar-mid kastaa wuxuu leeyahay qaab kale oo kiimiko ah iyo sidoo kale faa'iidooyin gaar ah iyo xaddidaadyo.
Sidee looga shaqeeyaa TNF Shaqada
Kaararka TNF waa nooc ka mid ah daroogada bayolojiga loo isticmaalo si loo daweeyo cudurrada dareenka sida RA. Inkastoo ay si gaar ah u bartilmaameedsanayaan TNF, cytokines bartilmaameedyada kale sida interleukin ama wax ka bedelaan habka unugyada difaaca (oo loo yaqaanno T-cells ama B-cells).
Kaararka TNF waxay noqdeen qalab muhiim u ah maamulka iyo daaweynta RA tan iyo markii ay bilaabeen 1998. Waxay ku shaqeeyaan si ka badan 70 boqolkiiba dadka qaba cudurka, oo ay ku jiraan kuwa aan ka jawaabin daaweynta methotrexate ee koowaad.
Marka la isku daro daawada methotrexate, daawada TNF waxaa loo yaqaanaa inay xitaa waxtar badan u leedahay dib usoo celinta tayada nolosha RA-da, inta badan muddo gaaban 12 asbuuc.
Kala duwanaanshaha Maamulka
Inkasta oo qaabka ficilka uu yahay mid ka badan ama ka yar sidii dhammaan seddex daroogo, Enbrel, Humira, iyo Qaadashada waxay leeyihiin tiro farqi weyn oo muhiim ah. Madaxa iyaga ka mid ah waa maamulka daawooyinka iyo inta jeer ee la isku daro.
Inkastoo ay jiri karto kala duwanaansho sida daawooyinka loo isticmaalo, waxaa guud ahaan loo qoraa sida soo socota:
- Faafinta waxaa la siiyaa cirbadda subcutaneous (maqaarka) hal mar ama laba jeer toddobaadkii.
- Humira waxaa la keenaa cirbadeynta subcutaneous toddobaadkii kale.
- Qaadashada waxay u baahan tahay infalawanso faleebo afar illaa siddeed toddobaad.
Waxaa intaa dheer, ka duwan Remicade, Enbrel iyo Humira ayaa isku maamuli kara qiyaasta daawada. qalin lagu mudo (sida kuwa ay isticmaalaan sonkorowga si loo yareeyo insulin).
Kala duwanaanshaha Waxtarka
Siyaabo kale oo daawooyinka ay u kala duwan yihiin waa celceliska mudnaanta waxtarka, taasoo micnaheedu yahay inta jeer ee aad isticmaali kartid inta aadan u baahneyn inaad bedesho daaweynta.
Dhamaan arrintan, daraasad cilmibaaris ah sannadka 2013 ayaa soo saartay jaamacadda Valladolid ee Spain oo baadhitaan ku samaysay celceliska muddada daaweynta ee Enbrel, Humira, iyo Qaadashada 91 qof oo leh RA.
Waxa ay ka heleen waxay ahayd in Enbrel iyo Humira labadaba ay ahaayeen mudo todobo sano ah (2,561 maalmood iyo 2,769 maalmood, siday u kala horreeyaan). Marka la barbardhigo, Remicade wuxuu lahaa celcelis ahaan daaweyn muddada daaweynta ee ka badan shan sano (1,853 maalmood).
Saddexda daroogo, Enbrel wuxuu muujiyey mudnaanta ugu sareysa ee waxqabadka, gaar ahaan haweenka daaweynayay celcelis ahaan sagaal sano (3,191 maalmood). Waxaa intaa dheer, dadka waayeelka ah ee Enbrel waxay aad ugu dhowdahay in ay isbeddelaan bayoolaji kale TNF.
Inkasta oo gabagabada ay ku kooban tahay heerka daraasaddan, cilmi-baarayaashu waxay soo gabagabeeyeen in, seddexda TNF inhibitorsada, Enbrel ay muujisay heer sare.
Kala duwanaanta Kharashka
Kaararka TNF waa kuwo aad u qaali ah marka loo eego daroogooyinka kale ee RA, arrinka taas oo khuseeya daaweyntaada.
Inkasta oo ay suuro gal tahay in daawada la iibsado ka dib marka la isugeynayo bixinta caymiska, qiimo dhimista tafaariiqda, iyo barnaamijyada gargaarka bukaanka, waxaad filan kartaa qiimaha guud in uu hoos u dhaco ama ka yaraado meerahan:
- Humira ayaa u dhexeysa $ 1,800 iyo $ 2,400 bishii.
- Celcelisada celceliska qiyaasta $ 4,000 bishii.
- Hal qadar ah Remicade ayaa ku kici kara meel kasta oo ka timaad $ 1,250 ilaa $ 2,500, iyada oo ku xidhan haddii aad u baahan tahay tallaal afar todobaad ama sideed usbuuc.
Iyada oo Remicade, waxaa sidoo kale muhiim ah in lagu sameeyo kharashka soo galinta isbitaalka. Taas bedelkeeda, Enbrel iyo Humira ma dhicin kharashaadkan haddii aad go'aansato inaad is-iskuduubto.
Ugu dambeyntii, kharashka runta ah ee daaweynta wuxuu ku xirnaan doonaa caymiskaaga iyo u-qalmitaanka taageerada lacag bixinta ee ay bixiyaan kuwa soo saaraha ee Enbrel, Humira, iyo Qaadashada.
> Isha:
> Martinez-Santana, V ,; Gonzalez-Sarmiento, E .; Calleja-Hernandez, M. et al. "Isbarbardhiga qiimaha badbaadada daroogada ee loogu talagalay cudurka kansarka necrosis ee antagonists ee rheumatoid arthritis." Bukaanku wuxuu door bidaa inuu raaco . 2013; 7: 719-27. DOI: 10.2147 / PPA.S47453.