Novantrone (mitoxantrone) da Tysabri (natalizumab) suna amfani dasu a cikin irin wannan yanayi don magance ƙwararrun sclerosis - ga mutanen da ke damuwa da sake dawowa da yawa-sclerosis (RRMS) ko kuma cigaba-sake dawowa da sclerosis (PRMS). Novantrone an nuna shi ne ga ƙwararrun sclerosis mai zurfi (SPMS), kuma Tysabri na iya taimakawa a cikin sashin SPMS inda raunuka masu aiki ke nunawa a kan MRI, da.
Babu wanda yake don MS na gaba-gaba.
Wannan yana nufin cewa mutane da yawa da suke da ɗaya daga waɗannan nau'ikan MS suna da zabi don yin: Tysabri ko Novantrone. Duk da yake yana da kyau idan mutum yana da haɓaka mai yawa fiye da ɗayan a kowane bangare, wannan ba haka bane. Kamar duk abinda yake tare da MS shine ya zama, yanke shawara na Tysabri vs. Novantrone ya dogara ne akan wani gungun abubuwa masu rikitarwa. Zaɓin ya kamata ya dogara ne akan fifiko na mutum da kuma salon rayuwa, shawarwarin likita da kuma damar, da kuma wasu dalilai kamar ƙimar, tsoro na ƙayyadadden sakamako da kulawa.
A cikin wannan labarin, na yi mafi kyau don gwada Tysabri zuwa Novantrone a gefe daya a kan wasu bangarori na magani da na san mutane sun fi sha'awar. Bari in nuna cewa wadannan kwayoyi suna da nau'i daban-daban na aikin , don haka ba kamar magungunan miyagun ƙwayoyi sunyi aikinsa "mafi kyau" - suna aikata abubuwa daban-daban, amma tare da manufa ɗaya na rage jinkirin rashin ciwo da kuma hana MS komawa.
Tysabri wata kwayar ne kawai wanda ke hana wasu ƙwayoyin T don su tsallake shinge na kwakwalwa, yayin Novantrone ne maganin cutar kariya wanda ke rufe aikin rigakafi.
Ga wasu abubuwa da za a yi la'akari da lokacin yin zabi:
Samun damarka da Kwarewa na Doctor
Sai kawai likitoci da aka yi rajistar tare da shirin TOUCH na saka idanu Tysabri.
Mutane da yawa wanda likita ba shi da damar yin amfani da Tysabri ya ƙare zuwa wani likitan ne wanda ke da damar shiga. Duk likita zai iya rubuta Novantrone, duk da haka, an ba da shawarar cewa likita zai yi aiki tare da kwarewa a kulawa da kulawa da marasa lafiya masu karbar maganin ilimin chemotherapy na wannan yanayi.
Hanyoyin Yanayi da Tsaro
Duk da yake bayanan haɗari na biyu da Tysabri da Novantrone sun bambanta, dukansu suna haifar da mummunar amsawa a cikin mutane da yawa - Tysabri yana da tarihin PML kuma Novantrone shine chemotherapy. A nan ne nauyin hade - Novantrone zai iya sa ka ji daɗin ciwo bayan jima na dan kwanaki, tare da abubuwa kamar vomiting / tashin zuciya, ƙananan ciwon mafitsara da kuma cututtuka na numfashi, kuma, da kyau, za ka iya rasa wasu gashi. A kan Tysabri, mai yiwuwa ba za ka ji kamar yadda aka yi ba a cikin kwanakin da za a yi jiko, kamar yadda abubuwan da suka fi dacewa da su su ne jigilar jini, gajiya, ciwon kai da haɗin gwiwa. Yanayin yanke shawara ga mutane da yawa na iya saukowa don zabar tsakanin (1.2 kowace 10,000) hadarin PML tare da Tysabri game da hadarin cutar sankarar bargo (7,4 a kowace 1,000) ko lalacewa ta zuciya tare da Novantrone.
Frequency
An yi amfani da Tysabri a cikin intravenously (ta hanyar IV a cikin gidan jiko ko a ofishin likita) sau daya a wata.
Novantrone ana gudanarwa a cikin kowane watanni 3.
Amfani da dogon lokaci
Tysabri (a wannan lokaci a lokaci) za'a iya amfani dashi har abada, kodayake kare lafiyar miyagun ƙwayoyi bayan shekaru 2 ba a sani ba. Novantrone, a gefe guda, za a iya amfani dashi har zuwa biyu zuwa shekaru uku (10 ko 11 allurai) a cikin rayuwar mai haƙuri.
Amfani
Amfanin magungunan sunyi kama da kamanni, amma wuya a kwatanta kai tsaye, saboda bambance-bambance a cikin zane-zane. A cikin nazarin shekaru 2, idan aka kwatanta da wani wuribo, Novantrone ya nuna cewa rage yawan relayes , ƙara tsawon lokaci tsakanin sake komawa baya, nuna kashi 61 cikin dari na lalata yawan mahalarta damar yin tafiya da kuma rashin rashin lafiyar jiki.
Tysabri ya nuna raguwar kashi 68 cikin raguwa fiye da shekaru biyu, har ma rage jinkirin ciwon rashin nakasa da kuma rage yawan sabon sakewa.
Haƙuri (Yanzu da Gabatarwa) da kuma Yarayar
Mata masu ciki ko ƙoƙarin yin ciki bazai dauki ko dai Tysabri ko Novantrone ba, kuma kada suyi amfani da su da mata masu nono. An dauke Tysabri a cikin "C-pregnancy C", ma'anar cewa ya haifar da mummunar cutar ga yara a cikin nazarin dabba amma ba a fahimci tasiri a cikin mutane ba. Ya kamata a dakatar da Tysabri na dan lokaci kafin ƙoƙarin yin ciki (yawanci daya zuwa watanni uku, tattauna wannan tare da likita). Novantrone tana dauke da shi a cikin "ciki mai suna Category D," ma'ana zai iya haifar da cutar tayi lokacin da aka yi wa mace mai ciki. Mata masu haihuwa suna buƙatar jarrabawar ciki kafin su sami kowane kashi na Novantrone.
MUHIMMAN DA MUHIMMAR: Wasu mata (5-30%) kammala cikakken tsari na Novantrone ba zata sake fara lokaci ba kuma basu da lafiya (ba za a yi ciki ba). Yana da mahimmanci a yi la'akari da wannan yiwuwar lokacin da za ku yanke shawara ko ku yi amfani da Novantrone ko ku tattauna shi da mijinku ko abokin tarayya. Binciken da aka yi kwanan nan ya nuna cewa za a iya rage yawan rashin lafiyar mace ta hanyar yin amfani da maganin hormone (maganin estroprogestinic) a lokacin da yake lura da Novantrone kuma wannan ya kamata a tattauna tare da likita.
Sulu-Medrol
Solu-Medrol, ciwon daji wanda ke amfani da ita don rage tsawon lokaci da kuma tsananin dawowa, ba a ba da shawarar ga mutanen da suke amfani da Tysabri a kalla wata daya kafin ko bayan jinsin karshe, saboda ƙarar rigakafi, ko da yake akwai wasu likitoci da za su rubuta shi a cikin batun sake dawowa kuma na ji labarin matsakaicin ƙwayoyin (125 zuwa 500 MG) da aka ba a lokaci ɗaya a matsayin jigilar Tysabri don taimakawa tare da ƙananan cututtuka na jiki zuwa Tysabri. A wani gefen kuma, Sulu-Medrol an ba da shi a lokaci guda kamar yadda aka yi da Novantrone jiko kuma ana iya ba da kyauta a cikin batun sake koma baya tsakanin Novusro da infusions.
Kulawa
Kafin farawa Novantrone, za kuyi gwaje-gwaje masu zuwa: jarrabawar jini (CBC, aikin hanta, ciki ga mata), electrocardiogram (EKG), da kuma echocardiogram a matsayin ƙaddamarwa na asali na haɓaka mai haɓaka na hagu (LVEF) ya kamata a yi kafin kowane kashi na Novantrone. Dole ne a dakatar da magani na Novantrone idan LVEF ya canza canji ko kuma ya kasance ƙarƙashin kashi 50%. Dukan gwaje-gwaje za a sake maimaita kafin kowace magani. Ba za a iya ba Tysabri ba ne kawai a wani wurin jiko wanda aka rajista ta hanyar shirin "TOUCH". "TOUCH" yana nufin "Tattaunawa na Tysabri: Ƙaddamar da Ɗaukaka ga Lafiya" kuma shi ne shirin da aka sanya a cikin ƙoƙari na kama duk wani matsala na PML a farkon matakan, da kuma hana su. Likita ko likita za a gwada ku kafin ku fara Tysabri, sa'an nan kuma ku duba kowane watanni 3 zuwa 6 don canza canji. Za a umarce ku don duba bayanan lafiyar lafiyar ku kuma ku cika wani bincike kafin kowane jiko.
Contraindications
Kada a yi amfani da mutanen Novantrone da cututtukan zuciya ko kuma shan wasu magunguna waɗanda zasu iya lalata zuciya, matsalolin hanta, ƙananan jini da jini mai tsabta, jini ƙin matsaloli, ciwon daji ko tarihin ciwon daji na baya. Bai kamata mutane su karbi Tysabri wanda ke ɗaukar magungunan immunosuppressants ko immunomodulators ko kuma mutanen da ke da tsarin rigakafi. Kada mutane suyi amfani da miyagun ƙwayoyi don kamuwa da cututtuka.
Kudin
Tysabri yana daya daga cikin maganin MS mafi tsada, a $ 28,400 a shekara don Tysabri kanta. Novantrone yana kimanin kimanin $ 3,000 a kowace shekara domin magani, yana sanya shi tsada. Dukansu sun zo tare da ƙarin farashi don cibiyar jiko.
Layin Ƙasa
Yanke shawarar yin amfani da Tysabri ko Novantrone wani abu ne mai mahimmanci, wanda yana iya zama mai sauƙi ko rikitarwa, dangane da abin da kake mayar da hankali ga ko abin da ya shafi ka (alal misali, wanda ya biya daga aljihun yana iya samun Novantrone sosai yana da sha'awa, yayin da matashiyar da ke son yara a nan gaba na iya kara karfi ga Tysabri). Idan likitanku yana da ra'ayi mai mahimmanci wata hanya ko wata, tabbatar da cewa ka tambaye shi don bayyana dalilai. Ko da yaushe kuna jin kyauta don samun wani ra'ayi idan har yanzu ba ku yarda ba. Zai yiwu cewa likitanku ba shi da damar yin amfani da Tysabri - idan kana son shi, sami likitan da ya yi kuma ya tambayi ra'ayinsa. Hakanan, zai iya zama likitan likitanku ta hanyar amfani da kwayoyi na chemotherapy, amma akwai wasu likitoci da suka yi amfani da Novantrone a daruruwan marasa lafiya tare da sakamako masu kyau. Ci gaba da neman amsoshi har sai kun yarda.
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