Aimovig shi ne wanda ya saba da kwayar cutar guda daya wanda ya hana migraines
Akwai nau'i biyu na farfadowa na migraine: abortive ko m. An yi amfani da maganin zubar da ciki a lokacin harin ƙaura, tare da manufar dakatar da shi. Hanyoyin tsere da kuma NSAID kamar kamfanoni da kuma ibuprofen (Advil) suna shayarwa.
Magunguna masu rigakafin ƙoƙari na rage ƙwanƙwasa da ƙananan ciwon kai. Wadannan magunguna suna rarraba su a matsayin magungunan ƙwayoyi masu magunguna (OMPMs) kuma sun hada da antidepressants, anticonvulsants, da beta-blockers.
A cikin labarin Nuwamba 2017 da aka wallafa a New England Journal of Medicine , Goadsby da masu marubuta sun bincika ikon Aimovig zuwa (erenumab) don hana hare-haren hauka. Ba kamar OMPM na yanzu ba, Aimovig wani samfurin ilimin halitta ne - wanda ya saba da shi. Musamman, Aimovig yana hana ƙwayar migraines ta hanyar katange mai karɓar lissafin peptide (CGRP) wanda aka danganta da nau'in calcitonin, wanda aka hade da haɓakawa na migraine.
Wanene ya haɗu da Aimovig gwaji?
A lokacin gwaje-gwaje na 2 da na gwaji na gwaji na 3, an gwada Aimovig akan marasa lafiya tare da ciwon ƙwayoyin cuta da kuma na kullum.
An bayyana jigilar ƙirar Episodic a matsayin miki fiye da 15 ko raunuka a kowace wata, ko dai tare da ko ba tare da motsi ba. An kwatanta lokuttan ƙaura na ƙananan ƙaura a kalla 15 kofuna a kowace wata. Akalla takwas daga cikin wadannan kwanaki goma sha biyar sune kwanaki na gudun hijira ko dai tare da ko ba tare da motsi ba.
Hawan episodic migraines sun fi kowa-game da kashi 90 cikin dari na mutane tare da migraines suna da su.
Daga tsakanin kashi 5 cikin dari da kashi 8 cikin dari na mutanen da ke cikin migraines suna da ciwon ƙwayar cuta.
Game da gwaji
A wani labarin Nuwamba 2017 da aka wallafa a New England Journal of Medicine , Goadsby da masu marubuta sun bincika ikon Aimovig don hana hare-haren hawan.
A cikin wannan binciken, akwai mahalarta matasan 995 suka rarraba zuwa ƙungiyoyi biyu na gwaji da kuma rukuni.
Kungiyar kulawa ta sami asibiti, kuma ƙungiyoyin gwaji sun karbi nau'in 70 MG ko kuma maganin da ake amfani da su na Aikivig na 140 mg, wanda aka gudanar a matsayin shida na asibiti da aka dakatar da makonni hudu.
A cewar mawallafa, duka maganin "rage yawan miyagun ƙaura, sakamakon ƙwayar cutar migraines a kan ayyukan yau da kullum, da kuma yin amfani da magungunan ƙwayar ƙwayar ƙwayar cuta ta musamman a tsawon watanni 6."
A cikin asali, yawan lokuta na gudun hijira da aka samu kowace wata ta mahalarta a cikin binciken shine 8.3 kwana. Tsakanin watanni hudu da shida na jiyya, adadin lokacin ƙaura ya ragu da 3.2 da 3.7 a cikin ƙungiyoyi 70-mg Aimovig da 140-mg Aimovig.
Daga tsakanin farkon binciken da watanni shida zuwa wata shida na jiyya, a cikin ƙungiyar 70-MG, kashi 43.3 cikin dari na marasa lafiya sun sami akalla kashi 50 na ragowar yawan lokacin ƙaura a kowace wata.
Tsakanin farkon binciken da hudu da watanni shida na jiyya, a cikin rukuni na 140-MG, kashi 50 cikin 100 na marasa lafiya sun sami akalla kashi 50 bisa dari na yawan lokuta na migraine a kowace wata.
Daga tsakanin farawar binciken da watanni hudu zuwa shida na jiyya, a cikin wadanda ake karbar su, kashi 26.6 cikin 100 sun samu akalla kashi 50 na ragowar yawan ƙaura a kowace wata.
Yawan kwanakin da aka yi amfani da magunguna don amfani da magungunan ƙwayoyi masu magunguna don rage ƙwayar ƙwayar ƙwayar cuta mai ƙaura daga kwanakin 1.1 a cikin ƙungiyar 70-MG da kuma 1.6 a cikin ƙungiyar 140-MG idan aka kwatanta da kwanaki 0.2 a cikin rukunin placebo.
Lalacewar ayyukan yau da kullum yana sa migraines debilitating. Yin amfani da tambayoyin, masu bincike sun yi la'akari da ingantaccen aikin da ake yi a yau. Sun sami gagarumin cigaba a waɗanda suka karbi Aimovig.
Hanyoyin Cutar da Ƙuntata
Kodayake yawancin masu halartar rahoton na rahoton Aimovig ne, wadannan abubuwan da suka faru ba su da bambanci daga wuraren da aka karɓa.
Musamman ma, mutane da yawa da ke karbar mikiyar Aimovig 70 na dauke da cutar a masallacin inji fiye da wadanda ke cikin rukunin kulawa.
Misalan abubuwan da suka faru da suka faru da yawa sun haɗa da sanyi, ƙwayar cutar na numfashi na sama, da sinusitis.
Ɗaya daga cikin iyakokin binciken shi ne cewa masu bincike basu hada da marasa lafiya wadanda basu samu kariya daga ilmin likita ba daga wasu koleji na OMPM.
Duk da haka, masu bincike sun hada da marasa lafiya wadanda suka dakatar da OMPM saboda rashin inganci, rashin amsawa, ko kuma mummunar tasiri. A gaskiya, kimanin kashi 38.7 cikin dari na marasa lafiya a cikin samfurin bai taba samun amfani daga OMPM ba.
Bugu da ƙari, bisa ga Goadsby da co-marubuta:
An tabbatar da gwagwarmaya a cikin gwaji na 2 na gwagwarmayar erenumab da ke dauke da marasa lafiya da ciwon daji, wanda kashi 68 cikin dari na marasa lafiya sun dakatar da shan magani ta asibiti saboda rashin rashin tasiri ko rashin tasiri.
Lokacin da aka hade tare da sakamakon daga wasu Fannin na II da na gwaji na 3 na gwaji na nazari game da amfani da Aimovig a cikin wadanda ke da gudun hijira da kuma episodic migraine, yana nuna cewa Aimovig zai iya taimakawa wajen hana episodic migraines.
Dole ne a gudanar da bincike da yawa don bunkasa Aimovig mai tsawon lokaci, da kuma tsawon lokacin da sakamakonsa ya wuce.
Ta yaya Aimovig ta ƙaddamar zuwa OMPMs?
Bambanci mai yawa tsakanin Aimovig da OMPM shine cewa Aimovig ya kebanta matakai na musamman wanda ke da tasiri a cikin ƙaura.
Ba a samu bincike ba don gwada lafiyar Aimovig tare da wasu magunguna da aka hana don hana ciwon kai na ciwon kai. Bugu da ƙari, babu bincike da yawa da ke nazarin tasirin OMPMs da kansu.
Bisa ga Cibiyar Nazari ta Ƙasar Amirka:
Babu tabbacin samuwa don yin jituwa tsakanin masu yawa a cikin ɗalibai; irin wannan shaidar zai samar da cikakken fahimtar tasirin tasiri da kuma jurewa a kan iyakar magungunan magunguna. Ana buƙatar nazarin da aka kimantawa sosai a yayin da ake amfani da maganin rigakafi da kuma yadda ake amfani da magunguna.
Abinda aka ƙididdige shi ne kawai na nazarin tasirin OMPMs. A cewar AAN, akwai wata hujja mai karfi ko matsakaicin shaidar da ke tabbatar da ingancin maganin rigakafi masu zuwa:
- Divalproex sodium, sodium valproate, da topiramate (maganin antiepileptic)
- Metoprolol, propranolol, timolol, atenolol, da kuma galol (beta-blockers)
- Amitriptyline da venlafaxine (antidepressants)
Bugu da ƙari kuma, gabapentin, lamotrigine, clomipramine, da kuma fluoxetine, waɗanda aka tsara don kare rigakafin, bazai da tasiri a hana ƙwayar cutar migraines.
Bayan bayanin kula, magani tare da kwayoyin cututtuka na bukatar kulawa da hankali ga pancreatitis, rashin hanta hanta, da kuma irin abubuwan da ke tattare da cutar kamar haihuwa. Bugu da ƙari, divalprox sodium na iya haifar da kimar nauyi. Har ya zuwa yanzu, yana nuna cewa Aimovig ba ya kawo irin wannan tasiri.
Abu daya da muka sani game da OMPMs shine adherence ba shi da kyau. A wasu kalmomi, yawancin mutanen da suke daukar wadannan magunguna sun dakatar da karbar su.
A cikin nazarin binciken da aka yi nazari a cikin littafin Cephalagia a shekarar 2015, Hepp da abokan aiki sun bincikar tasiri na 14 na OMPM don magance ƙwayar cutar migraines. Daga cikin marasa lafiya 8688, adadin biyan kuɗi a watanni shida ya kasance tsakanin kashi 26 da kashi 29 cikin 100. A watanni 12, ragowar farashin ya ragu a tsakanin kashi 17 da kashi 20 cikin 100.
Bisa ga marubuta:
Ko da yake dalilai na rashin amincewa ba a kama su a cikin bayanan da aka yi ba, binciken da aka wallafa a baya ya nuna cewa ƙila za a iya danganta ga wasu dalilai, ciki har da illa da kuma / ko rashin ingancin OMPM. Bugu da ƙari kuma, maganin kula da AAN kuma ya nuna cewa kaɗan daga cikin OMPMs yana da kyakkyawar shaida ta asibiti na ingancin su wajen hana ciwon kai.
Abin sha'awa shine, masu bincike sun gano cewa daga cikin gwaje-gwaje na 14 na OMPM, amitriptyline, nortriptyline, gabapentin, da divalprox suna da ƙananan adadin haɗuwa idan aka kwatanta da topiramate.
Neurostimulation
Ga batun mahimmanci tare da migraines: Ba mu fahimci yadda suke aiki ba. Ba tare da fahimtar irin abubuwan da wannan cututtuka ta yi ba, yana da wuya a ƙirƙirar magunguna da magungunan da suka saba da hanyoyi.
Ka yi la'akari da nassi na gaba daga nazarin bita na 2013 wanda ake taken "Migraine: kwakwalwa":
Abubuwan da ke tattare da ƙwayar cuta ta ƙaura sun fi mayar da hankali akan wani ɓangaren farko na farawa irin su shimfidawa ciki a cikin lalata ko kuma 'mahalarta tsara' a cikin kwakwalwa. Amma cigaba da ci gaba na kai hare-haren ƙaura yana nuna canje-canje guda ɗaya a cikin aiki na yankuna masu kwakwalwa da yawa, kuma ba a bayyana cewa akwai yanki guda daya wanda aka fara ƙaura a cikin dukkan marasa lafiya.
Kamar Aimovig, Cefaly yana nufin kai tsaye ya rushe pathogenesis na ƙaura ta hanyar dabarun makirci. Ba kamar Aimovig ba, wanda aka ba shi a matsayin allurar, Cefaly wani na'urar neurostimulation da aka sanya a goshinsa. Yana zubar da jijiyar cututtukan zuciya, wanda ake tsammani zai taka muhimmiyar rawa a cikin migraines.
Cefaly kwanan nan an amince da FDA ba kawai a matsayin magungunan rigakafi amma har ma da magungunan magunguna, ma. Ya zo a cikin uku model: Cefaly Acute, Cefaly Tsayar, da Cefaly Dual. (Cefaly Dual yana da hanyoyi ga duka m da kuma kare lafiyar migraines.)
Bisa ga masu sana'a, Cefaly Tsayawa na gudanar da aiki mai karfi wanda za'a iya amfani dashi yau da kullum don hana hare-haren hawan ƙaura.
A cikin gwaje-gwaje na asibiti, wanda ya faru tsakanin shekara ta 2009 zuwa 2012, wadanda ke karɓar maganin Cefaly don kare rigakafi sun samu raguwa a cikin ƙaura da kuma ciwon kai bayan kwana uku na amfani.
Mafi mahimmanci, marasa lafiya da suka karbi maganin Cefaly sun kamu da kashi 29.7 cikin dari na rani na ƙaura kuma kashi 32.3 cikin dari na kwanakin ciwon kai. Bugu da ƙari kuma, kashi 38.2 cikin dari na marasa lafiya da suka karbi Cefaly sun samu akalla kashi 50 na ragowar ƙaura a kowace wata.
Bugu da ƙari da fuskantar ƙananan ciwon hauka da ciwon kai, waɗanda suke amfani da Cefaly kuma suna buƙatar samun maganin maganin ƙwayar ƙwayar cutar shan magani ("magungunan ceto"). Daga bayanin kula, babu wani mummunar tasiri a cikin wadanda ke karɓar maganin Cefaly.
Yayin da Cefaly ke gudanar da bincike-bayanan bayanan kasuwa, kashi 53 cikin dari na marasa lafiya da suka karbi na'urar sunyi farin ciki da shi. Kashi 4 cikin dari na masu amfani sun ruwaito rashin jin dadi kuma sunyi rahoton cututtuka marasa rinjaye, irin su barci, ciwon kai, ko tingling da na'urar ta haifar. Kamar dai yadda gwajin gwagwarmaya, babu wani mummunar illa ga ilimin Cefaly.
Kalma Daga
Kodayake ba mu fahimci yadda ƙaurarin aiki ke aiki ba, sababbin abubuwan kirkiro kamar Aimovig samfurin halittu, da Cefaly na'urar neurostimulation, na nufin kawar da sassan wannan rashin lafiya. Aimovig bai riga ya amince da FDA ba, amma Cefaly yana samuwa. Idan kana sha'awar maganin wadannan ko sauran maganin rigakafi, tattauna su da likitan ka.
> Sources:
> Charles, A. Migraine: yanayin kwakwalwa. Bayani na yanzu a cikin Ma'anar Halitta. 2013; 26: 235-239.
> Neman Koyarwar Novo na Cefaly Na'ura . FDA.
> Goadsby PJ, et al. Jarabaccen Sarrafawa na Erenumab don Migraine Episodic. Jaridar New England Journal of Medicine. 2017; 377: 2123-2132.
> Hepp Z, et al. Biyowa ga magungunan miyagun ƙwayoyi masu magungunan ƙwayoyin cuta a cikin marasa lafiya da ciwon daji, Cephalagia. 2015; 35: 478-488.
> Riederer F, Penning S, Schoenen J. Transcutaneous Supraorbital Nerve Stimulation (t-SNS) tare da Cefaly Na'urar don Rigakafin Rigakafi: A Binciken Bayanan Da Ya Rasu. Pain da Far. 2015; 4: 135-137.