Jiyya na iya taimakawa wadanda ke da cutar cutar Parkinson gaba daya
A watan Maris 2017, FDA ta amince da safinamide (Xadago) don yin amfani da asibiti a Amurka. Safinamide ita ce sabuwar magani ta farko da FDA ta amince don magance cutar Parkinson a cikin shekaru 10. Yana da nau'i na daidaitacce, ko ƙarawa, wanda aka yi amfani da shi tare da levodopa.
An bayyana Maganar Parkinson ta Cutar
Cututtukan Parkinson ne cuta mai motsi wanda ya cigaba da cigaba kuma yakan fara a kusan shekaru 60.
Kwayoyin cututtuka sun hada da rawar jiki, raguwa, jinkirin motsi, da rashin daidaituwa. Wannan cututtukan yana haifar da matsaloli tare da tafiya, magana, da sauran ayyukan yau da kullum na rayuwar yau da kullum. A Amurka, kimanin mutane 50,000 suna fama da cutar ta Parkinson a kowace shekara.
Kodayake babu maganin cututtuka na cutar Parkinson, akwai maganin da ke taimakawa tare da gudanar da alamu, ciki har da waɗannan:
- levodopa
- dopamine agonists (misali, apomorphine, bromocriptine, ropinirole da pramipexole)
- magunguna na oxidase monoamine ko masu yin amfani da MAO-B (misali, sautin da kuma ractionline)
- Catechol-O-methyl-Transferase (COMT) masu hanawa (misali, caca da tolcapone)
- amantadine
- magungunan rigakafi, irin su Artane da Cogentin (yawanci aka ba wa 'yan ƙananan mutanen da waxanda suke ciki shine babbar alama)
Abin takaici, babu magani wanda zai jinkirta ko dakatar da ci gaban cutar ta Parkinson.
Levodopa shi ne mafi magungunan magani wanda yafi dacewa da cutar ta Parkinson; Duk da haka, sakamakonsa yana sa ran kashewa fiye da lokaci kuma zai iya haifar da mummunar illa gameda ciki har da dyskinesia .
Drugs ciki har da masu kwakwalwa COMT, masu maganin dopamine, da jiyya marasa magani-irin su magunguna da amantadine-za'a iya amfani da su azaman hanyoyin maye gurbin levodopa, ban da levodopa, ko hade da juna.
A cikin mutanen da ke fama da cutar Parkinson, lokacin da magunguna suka kasa, kwakwalwa na kwakwalwa (kwakwalwa ta kwakwalwa) za a iya daukar su don taimakawa wajen kawar da bayyanar cututtuka.
Yawanci, magunguna suna adana wa mutanen da alamun bayyanar sun zama mai tsanani don tsoma baki da ayyukan rayuwar yau da kullum. Levodopa yawanci shine miyagun ƙwayoyi na zabi a cikin mutane masu shekaru 65 da haihuwa wanda yawancin rayuwarsu suna fama da mummunar rikici. Mutanen da ba su da shekaru 65 za a iya bi da su tare da kwayar cutar dopamine.
Ana fara amfani da maganin ƙwayoyi a mafi mahimmancin maganin kuma magani yana yawan jinkirta azaman da zai yiwu. Duk da haka, binciken da ke taimakawa wajen jagorancin "farawa da jinkirin" tare da yin amfani da levodopa yana hade. A cewar marubucin Peter Jenner:
Gabatar da L-Dopa a cikin waɗanda ke da tsawon lokaci na cututtuka ko kuma a cikin dogayen ƙwayar zai iya haifar da lokacin da ya ragu da kyau kafin matsalolin motsa jiki ya bayyana. Kwanan nan, ajiye jigon L-dopa a sama da 400 MG kowace rana a farkon PD aka nuna don rage haɗarin dyskinesia induction.
Duk da haka, Jenner ya lura da haka:
Amfani da L-dopa da farko ya kuma nuna cewa ya zama mafi mahimmanci maganin cututtuka na motsa jiki kuma ba zai shawo kan hadarin dyskinesia na dogon lokaci ba.
Tabbas, irin wadannan sharuɗɗan shaida sun nuna yadda muka sani game da pathology da magani na cutar Parkinson.
Safinamide: Ta yaya Yayi aiki?
A cikin mutanen da ke fama da cutar Parkinson, kwakwalwa baya samar da isasshen mai amfani da kwayar cutar da ake kira dopamine .
Kwayoyin da suke samar da dopamine ko dai suna mutuwa ko suka zama marasa lafiya. Dopamine wajibi ne don kula da motoci da motsi.
Musamman, dopamine yana watsa sigina a cikin kwakwalwa wanda ke da alaka da sassauci, maɗauran motsi kamar cin abinci, rubutu, da rubutu. Kamar sautin da magunguna, safinamide wani nau'i ne mai hana MAO-B, wanda zai hana katsewar dopamine kuma ya kara girman matakan a kwakwalwa.
Na bayanin kula, safinamide ma modulates slutamate saki; Duk da haka, ba a sani ba sakamakon wannan aikin na maganin warkewar miyagun ƙwayoyi.
Ba kamar sauran maƙallacin MAO-B ba, wanda za'a iya tsara shi kadai ga wadanda ke da cutar cutar Parkinson, ana nufin amfani da maganin safinamide tare da wasu nau'o'in maganin rigakafi don cutar da baya-baya, mafi mahimmanci levodopa da dopon agonists.
A lokacin da mutane suka fara fara magani don bayyanar cututtukan Parkinson, kwayoyi sunyi aiki da kyau kuma ana nuna mana bayyanar cututtuka cikin yini. Daga tsakanin shekaru biyar da goma, duk da haka, inganci na kwayoyin kwayoyi na Parkinson ya wanke a cikin mutane da yawa, kuma tsarin kula da kwayar cutar ya zama mafi wuya a sauƙaƙe.
Musamman, a cikin mutane tare da tsakiyar zuwa ƙarshen cutar cutar Parkinson, hawan motsa jiki ko motsi na muscle na hannu (dyskinesia da daskarewa ) fara farawa.
Dyskinesia da aka fi sani a cikin mutane suna daukar levodopa kuma yana da mummunar tasirin magani. Harshen dyskinesia ya yi mummunan aiki game da hangen nesa kuma ya kamata a jinkirta ya jinkirta tsawon lokacin da zai yiwu. Bugu da ƙari kuma, rashin alamun motsa jiki, irin su lalata , damuwa, da kuma hallucinations, wadanda basu da alaka da kwayoyi masu magunguna, har ma sun zama matsala.
Wadannan marasa lafiya da suka raguwa bayan da suka dace da maganin da suka dade yana da wuya a bi da su a wata hanyar da ke kula da motsi da kuma rayuwar rayuwa.
A wasu kalmomi, da zarar levodopa ya dakatar da aiki, a wani ɓangare saboda ba mu fahimci irin wannan yanayin ba, yana da wuya a mayar da mutane zuwa mafita mai kyau da kuma rayuwar rayuwar da aka samu a baya a lokacin cutar yayin da levodopa da sauran jami'o'in dopaminergic suna aiki.
Bugu da ƙari, koda kuwa matsaloli na motsa jiki sun sake komawa ciki, rashin motar motsa jiki kamar rikitarwa na yanayi, damuwa da barci, da rikice-rikice ya zama masu wahala ga waɗanda ke da cutar ta Parkinson.
Abin takaici, ba zamu iya hango ko wane ne mutanen da suka kamu da kwayar cutar Parkinson za su cigaba da haɓaka da kuma matsala ba. Yawancin lokaci, tsawon lokaci na cutar, mataki na cututtuka, tsawon magani tare da levodopa, jima'i na levodopa, jinsi, da kuma nauyin jikin mutum dukkanan sunyi imani da cewa suna taka rawar gani a cikin fansa.
ON Times da OFF Times
"A lokacin" yana nufin lokaci lokacin da magunguna suke aiki da kyau kuma alamun cutar cutar Parkinson suna sarrafawa.
"Lokacin ƙare" yana nufin lokaci lokacin da magungunan ke motsawa da kuma bayyanar cututtukan Parkinson, irin su rudani, rigidity, da kuma wahalar tafiya tafiya.
Ƙarin safinamide zuwa tsarin miyagun ƙwayoyi na mutanen da ke fama da cutar Parkinson da ke shan levodopa yana ƙaruwa yawan lokacin ON da kuma rage yawan lokaci.
Safinamide Clinical Trials
Sakamako daga gwaje-gwaje na asibitoci guda biyu sun ba da haske game da amfanin amfanin da aka yi amfani da maganin safinamide tsakanin mutanen dake fama da cutar Parkinson. Wadannan mahalarta an gano su tare da cutar Parkinson a tsawon shekaru uku ko biyar.
Gwajin gwaji na farko ya tantance mahalarta 669 tare da hawan motsi. Wadannan mahalarta sun karbi safinamide tare da sauran magungunan rigakafi ko wurinbo (no safinamide) da sauran kwayoyi masu cutar antiparkinson.
Matsayi ON lokacin mahalarta ya kasance tsakanin 9.3 da 9.5 hours. Bayan watanni shida na gwaji, lokutan sau ya karu a duka jinsin marasa lafiya; Duk da haka, lokutan sun kasance kimanin minti 30 a cikin wadanda ke daukar safinamide.
Bayan shekaru biyu na jiyya, matsakaicin lokacin da ya kasance a cikin wadanda ke shan safinamide amma ya rage a cikin waɗanda ke daukar wuribo. Saboda haka bayan shekaru biyu a matsakaici, masu halartar safinamide tare da levodopa da sauran magungunan maganin antiparkinson sun san kimanin sa'a guda daya na maganin lafiyar cutar rashin lafiyar Parkinson.
Na bayanin kula, safinamide rage KASHE lokaci ta kimanin minti 35. Ka tuna cewa lokuttan da aka ƙayyade suna zuwa lokaci lokacin da kwayoyin cutar antiparkinson suka kashe, kuma bayyanar cututtuka kamar raguwa suna sake karawa.
Bugu da ƙari, ƙaruwa a kan sau na zamani da kuma rage wa'adin sau da yawa, safinamide kuma ya inganta motsi (ƙananan motsi) a waɗanda suke ɗaukan shi. Bugu da ƙari kuma a mafi mahimmanci, safinamide kuma ya taimaka tare da ayyukan rayuwar yau da kullum da kuma rayuwar rayuwa.
Hakazalika sakamakon sakamakon gwaji na biyu, wanda ya hada da mahalarta 549, ya ba da shawara cewa karuwa a cikin lokaci guda ta kimanin sa'a ɗaya a cikin wadanda ke daukar safinamide idan aka kwatanta da wadanda ke shafewa da kuma ragewa a KASHE lokaci. Bugu da ƙari, an kuma inganta cigaba da aiki da kuma ingancin rayuwa.
Safinamide Negative Side Effects
Saboda mummunar tasiri, kashi 3.7 cikin dari na masu halartar safinamide sun fita daga gwajin gwaji idan aka kwatanta da kashi 2.4 cikin dari na wadanda ke daukar wuri.
Abubuwa masu rikitarwa na al'ada da aka gani a lokacin wadannan gwaji sun haɗa da wadannan:
- ƴan tsauri ko ƙaddamarwa (watau dyskinesia)
- da yawa
- tashin zuciya
- rashin barci
Daga cikin wadannan bayyanar cututtukan, dyskinesia ya kasance sau biyu a matsayin na kowa a cikin mutanen da ke daukar safinamide idan aka kwatanta da wadanda ba su karɓa (watau wadanda ke zaune).
Sakamakon da ba a sani ba amma mafi tsanani mummunan abubuwa sun haɗa da wadannan:
- yana ƙara cutar karfin jini
- ninkin gani da kuma halin kirki
- barci a lokacin rana
- serotonin ciwo (lokacin da aka yi amfani da masu magunguna na MAO, antidepressants, da opioids)
- matsalolin matsalolin motsa jiki ko tilasta halayyar (tunanin OCD)
- zazzabi da rikicewa
- matsalolin retinal
Ga wadansu kwayoyi da ba za ku dauka ba idan kuna shan safinamide:
- wasu antidepressants (serotonin-norepinephrine reuptake inhibitors, tricyclics, da tetracyclics)
- cyclobenzaprine
- dextromorphan (aka samu a wasu maganin maganin tari)
- opioids
- St. John's Wort
Kodayake mutane da rashin nauyin koda zasu iya daukar safinamide, wadanda ke fama da matsalolin hanta mai tsanani kada su dauki magani.
Layin Ƙasa
Safinamide ya fi dacewa a cikin waɗanda suke da tsakiyar - zuwa ga rushewar cutar cutar Parkinson wanda ke fama da hawan motsa jiki (watau dyskinesia) da kuma rage yawan maganin magunguna (watau lokacin da aka kashe). Safinamide zai iya zama mafi mahimman ci gaba ga maganin farko tare da levodopa fiye da sauran magunguna, ciki har da wasu maƙallacin MAO-B da kuma masu hanawa COMT. Za a iya amfani da Safinamide a hade tare da levodopa da wasu kwayoyi antiparkinson. Ba a yi amfani da Safinamide kadai ba.
Sakamakon safinamide mafi mahimmanci na yau da kullum shine dyskenesia, ko karuwa a cikin ƙungiyoyi masu aiki. Mutanen da ke fama da matsalolin hanta mai tsanani ko waɗanda ke shan wasu antidepressants ko wasu magunguna ba za su dauki safinamide ba.
> Sources:
> Chaplin, S. Safinamide: Ƙara-tsaren Farko na Cutar Parkinson. Mai ba da labari. 2016.
> FDA ta amince da maganin cututtuka don magance cutar ta Parkinson. Maris 21, 2017. www.fda.gov.
> Jenner, P. Jiyya na Ƙarshen Bayanin Cututtukan Lafiya na Parkinson - Harkokin Pharmacological A yanzu da kuma a cikin Future. Translation Neurodegeneration. 2015; 4: 3.
> Jankovic, J, da Aguilar, LG. Abubuwan da ke faruwa a yanzu don maganin cututtuka na Parkinson. Ƙungiyar Neuropsychiatric da Jiyya. 2008; 4 (4): 743-757.
> Schapira, AH, et al. Bincike na Tsaro da Inganci na Safinamide a matsayin Levodopa Adjunct a cikin marasa lafiya tare da Cutinson Cututtuka da Rarraba Hoto Wani Gwajin Clinical Random. JAMA Neurology. 2017; 74 (2): 216-224.