Manufar magungunan ƙwayar ƙwayar cuta shine rage yawan da ƙananan ciwon kai.
Amma duk da haka masu amfani da magungunan ƙwayoyin cuta na yau da kullum, kamar Topamax (topiramate), Indiya (propranolol), da Elavil (amitriptyline), ba sau da tasiri kamar yadda mutane suke so. Bugu da ƙari, waɗannan magunguna suna da sakamako masu illa wanda yakan haifar da katsewa.
Bisa gagarumar labari shine masu bincike suna mayar da hankali sosai a kan bunkasa magungunan magungunan ƙwayoyin cuta. Daya daga cikin furotin da aka tsara da wadannan magunguna shine maganin peptide na kwayoyin lissafi (CGRP), wanda aka samo a daukaka a cikin mutane yayin hare-hare na migraine.
Bugu da ƙari, magunguna guda biyu, fremanezumab da erenumab, sun nuna alƙawari a cikin gwaje-gwaje na zamani 3-lokaci mai farin ciki ga masu gudun hijira da likitoci da kuma ƙaunatattun su.
Bari mu dubi waɗannan ƙwayoyi masu amfani da CGRP masu tasowa.
Erenumab don hanawa Episodic Migraine
Erenumab shi ne mai cin zarafi na mutum daya, kuma yana ɗaure ga mai karɓa na CGRP (shafin yanar gizon gina jiki).
Duk da yake ba a fahimci ainihin aikin da ake yi na erenumab ba, masana sun san cewa an cire CGRP daga wasu zarge-zarge na azabar ƙwayoyin cuta a lokacin harin ƙaura. Da zarar aka saki, CGRP ba wai kawai ya shiga cikin sakon sakonni ba, amma kuma yana haifar da kwantar da jini a waje da cikin kwanyar.
Tare da wannan, ta hanyar erenumab ta hana shafin yanar gizo na CGRP, masu bincike sunyi zaton cewa za a iya katse kai hare-haren ƙaura - kuma yanzu akwai kyakkyawan bayanai don tallafawa wannan ka'idar.
A cikin gwaji na uku a Jaridar New England Journal of Medicine , fiye da 900 masu halartar migraine episodic (wanda aka bayyana a matsayin ƙananan migraines fiye da 15 a kowane wata), aka bazu don samun daya daga cikin wadannan maganin uku a kowane wata don watanni shida:
- Abun daji na 70 na MG (ƙarƙashin fatar jikinka) da inji na erenumab
- Kwararru mai cututtukan daji na miliyon 14 da hamsin
- A allura subcutaneous injection
Mahalarta ko masu binciken sun san wanda ke karɓar raunin da yake ciki a kan gurbin gurgunta, wanda shine dalilin da ya sa aka yi binciken wannan bincike na makafi guda biyu.
Sakamako
Sakamakon binciken ya nuna cewa yawan watanni na migraine a kowace wata ya rage kwanakin 3.2 a cikin magungunan magani na 70-MG da kuma kwanaki 3.7 a cikin magungunan magani na 140-mg, idan aka kwatanta da kwanaki 1.8 a cikin ƙungiyar placebo.
Bayan nazarin ilimin lissafi, masu binciken sun yanke shawarar cewa wannan sakamakon ya kasance muhimmi. Wannan yana nufin cewa haɓakar da aka haɓaka a cikin rukunin masu jiyya shine ainihin (saboda sakamakon miyagun ƙwayoyi) kuma ba kuskuren binciken bazuwar ba.
Sakamakon ya nuna cewa game da rabi na mahalarta karbar erenumab sun sami kashi 50 ko ragu a cikin adadi na ƙaura a kowace wata idan aka kwatanta da kimanin kashi ɗaya cikin dari na wadanda ke cikin placebo kungiyar, wannan sakamakon ya zama muhimmi.
Ƙungiyoyin magunguna sun sami raguwa mai yawa a cikin kwanakin da ake bukata don amfani da magungunan ƙwayar magungunan ƙwayar cuta , kamar yadda aka kwatanta da kungiyar.
A ƙarshe, mahalarta a cikin binciken sun kammala sikelin da ake kira Migraine Dattijan Impact Diary, wanda mafi girma ci gaba nuna wani nauyin ƙaura mafi girma a kan aiki.
Sakamako a cikin nakasar jiki da ayyukan yau da kullum ya inganta sosai ga ƙungiyoyin kulawa idan aka kwatanta da ƙungiyar placebo.
Hanyoyin Kyau
Hanyoyin abubuwan da suka faru sun kasance daidai tsakanin masu halartar taron da suka karbi erenumab da mahalarta wadanda suka karbi placebo. A takaice, kasa da kashi 3 cikin dari na dukan masu halartar taron sun janye daga fitina saboda mummunar tasiri.
Kammalawa
Wadannan sakamakon sun nuna cewa erenumab yana da tasiri (a duka sassan) don hana ƙaurar episodic a wasu mutane. Erenumab ya bayyana cewa yana da kyakkyawan bayanin haɗin. Wannan shi ne jawabi maraba kamar yadda masu shan magungunan ƙwayoyi na yau da kullum suna katsewa saboda sakamakon da ba'a so.
Fremanezumab don hana ƙwayar Migraine
Fremanezumab shi ne wani mutum wanda yake da alaka da kwayar halitta guda daya wanda ke ɗaukakar kamfanin na CGRP na ainihi, wanda ya saba da mai karɓarta (kamar erenumab).
A cikin gwaji na uku a cikin New England Journal of Medicine , fiye da mutane dubu da ke da ciwon ƙwayar cuta (wanda aka fi sani da fiye da 15 migraines a kowane wata na akalla watanni uku), an ba da izinin samun ɗaya daga cikin tsarin uku na gaba a mako guda lokacin:
- Wata magungunan subcutaneous guda daya na fremanezumab a asali, daga bisani a cikin guraben sabo na wuribo a mako 4 da sati 8 (wanda ake kira kwata kwata-kwata)
- Abubuwa uku na cututtuka na fremanezumab tare da daya a ma'auni, daya a mako 4, da daya a mako 8 (da ake kira dawa kowane wata)
- A allura subcutaneous allura a farkon, mako 4, da kuma mako 8
Kamar jarrabawar erenumab, mahalarta da masu bincike sun kasance masu makanta ga wadanda ke karbar maganin da aka yi wa wanda ke karbar wuri.
Yayin da aka shirya mahalarta ziyara guda biyar (a lokacin da ake nunawa, asali, mako hudu, mako takwas, sannan kuma mako 12), duk bayanan ciwon halayen da aka rubuta a kowace rana ta hanyar na'urar jarrabawar lantarki. Misali na bayanan ciwon kai sun hada da ciwon kai, tsawon lokacinsa, da ciwo mai tsanani.
Sakamako
Sakamakon wannan binciken ya nuna cewa mahalarta sun karbi magunguna na fremanezumab ko uku na asibiti na fremanezumab suna da raguwa mai yawa a cikin adadin ƙaura a kowace wata, idan aka kwatanta da ƙungiyar placebo.
Mafi mahimmanci, mahalarta masu karɓar wuri suna da matsakaicin kwanaki 10 na rani na migraine tare da wadanda ke karbar fremanezumab kowace shekara (8.5 kwanakin) da kowane wata (8.0).
Bugu da ƙari, akwai kuma raguwa da yawa a cikin yawan adadin kwanakin da mahalarta ke bukata don amfani da magungunan ƙwayar magungunan ƙwayoyi a cikin ƙungiyar kula da ƙungiyar placebo.
A ƙarshe, an sami raguwa mai yawa a cikin rashin lafiya na nakasa (kamar yadda aka auna ta hanyar sikelin da ake kira Test Test Impact) don ƙungiyar kula da ƙungiyar placebo.
Hanyoyin Kyau
Abinda yafi rinjaye a cikin binciken shine jin zafi a wurin ginin, wanda ya faru fiye da mahalarta karbar fremanezumab fiye da mahalarta karbi wuribo. Duk da haka, tsananin da halayen ba ya bambanta tsakanin kungiyoyi, yana faruwa kusan kusan ɗaya a cikin ƙungiyoyi uku.
Bugu da ƙari, akwai wasu ƙananan halayen halayen enzyme hanta a cikin takwas daga cikin mahalarta ɗauke da fremanezumab. Matakan, duk da haka, sun koma al'ada, saboda haka ba a dakatar da mahalarta daga binciken ba.
A gaskiya ma, da masu bincike na binciken, duk waɗannan mahalarta sunyi amfani da magunguna kamar anti-inflammatory (NSAIDs) ko Tylenol (acetaminophen) akai-akai ko kuma antidepressants yau da kullum. Yin amfani da waɗannan magunguna na iya bayyana waɗannan hawan enzyme masu haɗari masu haɗari, musamman tun lokacin da fremanezumab ba a ciwo a cikin hanta ba.
Kammalawa
A cikin wannan gwaji na 3, fremanezumab da aka bayar a kowane lokaci ko kowane wata yana da amfani wajen hana ƙwayar ƙwayar cuta. Ba wai kawai rage yawan ƙananan watanni na migraine a wata (game da biyu ba), amma ya rage rashin lafiyar haɗin kangin.
Kalma Daga
Lamarin nan shine cewa wadannan magunguna, waɗanda suka fi dacewa da ƙauraran ƙwayoyi (magunguna masu rigaya sun tsara don magance wasu yanayi, kamar kama da damuwa), ba da bege da kuma wani zaɓi ga mutane. Ba su da cikakke, duk da haka, suna tallafawa tunaninsu cewa ana bukatar fitina da kuma kuskuren lokacin da aka fitar da shirin ƙirarku na ƙaura.
Bugu da ƙari da kasancewa mai tasiri wajen hana ƙwayar cutar migraines a cikin wasu mutane, waɗannan maganganu guda biyu masu amfani da CGRP sun kasance sun yi haƙuri-nau'i na biyu. Wannan ya ce, ana buƙatar ƙarin nazari don nazarin lafiyar da ake amfani da su na tsawon lokaci.
Bugu da ƙari, an yi watsi da masu binciken motsa jiki a cikin waɗannan littattafai idan sun ba da amsa ga nau'o'i biyu na magungunan magungunan ƙwayoyi na migraine. Don haka, yana da wuya a ce ko erenumab, fremanezumab, ko wasu maganin da aka yi amfani da su a CGRP a cikin bututun mai zai zama tasiri mai kyau ga mutanen da ke da ƙwayar ƙaura .
Bugu da ƙari, binciken da aka bincika ne kawai tsofaffi, don haka jarrabawa da ke nazarin yara da matasa tare da migraine suna buƙata.
> Sources:
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> Buse DC et al. Rawancin ƙwayar ƙaura, rashin nakasa, da kuma abubuwan da suka shafi zamantakewar al'umma: sakamakon daga Cibiyar Nazarin Harkokin Lafiyar Jama'ar Amirka da Rigakafin. Ciwon kai. 2012 Nov-Dec; 52 (10): 1456-70.
> Goadsby PJ et al. Gwajin gwagwarmaya na erenumab don migraine episodic. N Engl J Med 2017; 377: 2123-32.
> Schuster NM, Madaidaicin AM. Ka'idojin maganin peptide-wanda ake danganta da kwayar cutar ta Calcitonin don ƙwayar cuta da kuma ciwon kai: Abinda ke ciki. Clin Neuropharmacol . 2017 Jul / Aug; 40 (4): 169-74.
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