Rubuce-rubucen Litattafan Za a iya Bi da Duk 6 Riguna a cikin makonni 8
Mavyret (glecapravir, pibrentasvir) wani maganin hade ne mai maganin ƙwayar cuta wanda aka yi amfani dashi wajen kula da cutar rashin ciwon hawan Cutar Harshen C (HCV) . Magunguna da aka yi amfani da su a cikin aikin Mavyret ta hanyar hana kwayoyin sunadarai guda biyu da cutar ta buƙaci a yi.
An amince da Mavyret a ranar 3 ga Agusta, 2017, ta Cibiyar Abinci da Drugurman {asar Amirka, don amfani da manya da shekaru 18 da haihuwa. Binciken ya nuna cewa miyagun ƙwayoyi zai iya samun maganin maganin magani daga kashi 92 cikin dari da kashi 100 bisa nau'in jujjuya na HCV, wani adadi wanda ya fi dacewa da sauran magungunan rigakafi (DAA) a halin yanzu ana amfani da su a ciwon hawan Citadic C.
Sharuɗɗa da Fursunoni
Mavyret zai iya magance dukan nau'in HCV shida ( genotypes ) kuma za a iya amfani dashi a cikin mutanen da ba a taba bayyana su ba a cikin kwayoyin HCV da waɗanda suka rigaya sun kasa maganin. Bugu da ƙari, za a iya amfani da miyagun ƙwayoyi a cikin mutane tare da cirrhosis da aka biya (abin da hanta yake aiki har yanzu).
Mavyret yana da amfani guda daya akan wasu kwayoyi masu kama da shi don yana iya maganin rashin lafiyar hepatitis C a cikin makonni takwas. Duk sauran kwayoyi ba su buƙatar kimanin makonni 12 don sababbin marasa lafiya. Wannan ya hada da hada haɗin Jirgin HCV na Epiclusa wadda aka yarda da dukkanin kwayoyin shida.
Duk da haka, ba kamar Epclusa ba, Mavyret ba za a iya amfani da shi a cikin mutane da ke da nau'in cirrhosis ba (wanda ba'a aiki ba).
Wani bambancin maɓalli shine farashin . Ganin cewa kwayoyi kamar Epiclusa suna ɗaukar nauyin farashi na kimanin $ 75,000 na tsawon makonni 12 (ko $ 890 a kowace kwaya), an bayar da Mavyret a $ 26,400 na mako takwas (ko $ 439 ta kwamfutar hannu).
Bambancin farashin zai iya isa don shawo kan masu sayen lafiyar jiki don fadada magani ga 'yan Amirka miliyan 3.9 da ke fama da cutar HCV, mafi yawansu suna jira har sai akwai rashin ciwon hanta kafin magani zai iya yarda.
Bayyana shawarwarin
Maganin shawarar Mavyret shine uku da ake amfani dashi a kowace rana tare da abinci.
Kowane kwamfutar hannu yana dauke da milligrams 100 na glecaprevir da milligrams na pibrentasvir. Allunan suna launin ruwan hoda, nau'i mai tsalle-tsalle, mai rufi na fim, kuma an rubuta su da "NXT" a gefe ɗaya.
Yayin da ake amfani da ita ya bambanta ta hanyar HCV genotype, jiyya, da halin hanta na mai haƙuri, kamar haka:
- A baya an hana shi ba tare da wani cirrhosis ba: makonni takwas
- A baya an hana shi tare da cirrhosis da aka biya: makonni 12
- A baya an bi da su tare da HCV genotypes 1, 2, 4, 5, da 6 ba tare da cirrhosis ba: takwas zuwa 16 makonni dangane da farfadowa na baya
- A baya an bi da su tare da HCV genotypes 1, 2, 4, 5, da 6 tare da cirrhosis da aka biya: 12 zuwa 16 makonni dangane da farfadowa na baya
- An riga an bi da shi tare da HCV genotype 3 tare da ko ba tare da cirrhosis: makonni 16 ba
Kimanin kashi 75 cikin 100 na jama'ar Amurkan tare da hepatitis C suna da genotype 1, wanda shine mafi rinjaye amma har ma mafi wuya a bi da ita. Ya bambanta, tsakanin 20 zuwa 25 bisa dari na da siffofi na 2 da 3, yayin da ƙananan ƙananan kawai suna da kwayoyin 4, 5, ko 6.
Hanyoyin Gaba
Sabuwar ƙarni DAW kamar Mavyret suna da tasiri fiye da rassa fiye da tsohuwar tsararraki, wanda yawancin cikinsu sun hada da magungunan ƙwayoyi da ke cikin ƙwayoyin cuta ( peginterferon ) da ribavirin . Abubuwa masu rinjaye mafi yawan sun hada da Mavyret (faruwa a cikin kashi biyar cikin marasa lafiya) sun haɗa da:
- Ciwon kai
- Wulo
- Jiɗa
- Diarrhea
Yayinda yake magana, illa masu tasiri na iya sarrafawa kuma suna inganta ingantaccen lokaci. A gaskiya ma, bincike na kasuwa na farko ya tabbatar da cewa kasa da kashi ɗaya cikin dari na mutane a kan Mavyret ya dakatar da magani saboda sakamakon rashin illa.
Drug Interactions
Yin amfani da magungunan maganin rifampin, wanda aka saba amfani da su don magance tarin fuka, an hana su da amfani da Mavyret kuma ya kamata a katse kafin fara magani. Wadannan sun hada da kwayoyi tare da alamun suna Mycobutin, Rifater, Rifamate, Rimactane, Rifadin, da Priftin.
Wasu magunguna an san su suyi hulɗa tare da Mavyret kuma suna iya ƙara ko rage ƙaddamar da Mavyret cikin jini.
Wadannan ba su da shawarar don amfani tare da Mavyret:
- Carbamepazine, da ake amfani dasu don magance cututtuka da cututtuka
- Ethinyl estradiol (estrogene) - rike da magungunan haihuwa
- Sustiva (efavirenz) yayi amfani da cutar HIV
- Atorvastatin, lovastatin, da kuma simvastatin da ake amfani dasu ga babban cholesterol
- St. John's Wort
Raunin Samun
Mavyret an saba wa amfani da shi a cikin mutane masu fama da hanta mai hasara (kamar yadda aka auna ta hanyar Cutar Child-Pugh na C) kuma ba a ba da shawarar ga kowa ba tare da rashin lalacewa (Child-Pugh B).
An bada shawarar gwada aikin gwagwarmayar kafin fara fara don kauce wa rikitarwa. Har ila yau, jaririn Child-Pugh yana da amfani wajen tantance ƙimar cutar hanta da ke dogara da gwaje-gwajen jini da kuma nazari akan alamun bayyanar.
Hawan Ciwon B B
Mavyret ya kamata a yi amfani da hankali a cikin mutanen da ke da ciwon hauka B da hepatitis C. An gano cutar cutar hepatitis B (HBV) a lokacin ko kuma bayan jimawa. Za'a iya haɗawa tare da bayyanar cututtuka na jaundice da hanta ƙumburi. Idan magani bai tsaya nan da nan ba, sakewa zai iya haifar da gazawar hanta har ma da mutuwa.
Yayinda kamuwa da HBV ba ya sabawa amfani da Mavyret, zai buƙaci kulawa da haɗin enzymes na hanta don gano alamun farawa na farko.
A Ciki
Yayinda Mavyret ba ya saba wa juna a cikin ciki, akwai ƙananan bayanan asibiti na mutum don tantance ainihin hadarin. Da wannan aka ce, binciken dabba ya nuna cewa yin amfani da glecaprevir da pibrentasvir a lokacin daukar ciki ba a hade da mahaukaciyar tayi, ciki har da nunawa a lokacin yaduwa.
Ana ba da shawarwari na musamman don ba da la'akari da amfani da hadarin magani ba amma don taimakawa wajen gane ko maganin gaggawa ne ko wani abu da za a iya jinkirta har sai bayan bayarwa.
Don hana ciwon ciki a lokacin jiyya, ana shawarci ma'aurata amfani da akalla hanyoyi biyu marasa amfani na magunguna a lokacin kuma har zuwa watanni shida bayan kammala aikin farfadowa. Tun lokacin da ba'a bada shawarar kula da haihuwa a cikin hawan estrogen, yi magana da likitanka don ganin ko maganin rigakafin kwayar cutar kawai ne mai dacewa.
> Sources:
> Abbie, Inc. "Karin Bayani na Bayanan Magana : Mavyret (glecaprevir da pibrentasvir) Allunan, don yin amfani da murya Amfani da Amincewar US: 2017." Chicago, Illinois; updated December 2017.
> Foster, G .; Gane, E; Asatryan, A. et al. "DUNIYA-3: aminci da inganci na glecaprevir / pibrentasvir idan aka kwatanta da sofosbuvir da daclatasvir a magani-marasa ciwon HCV genotype marasa lafiya 3-marasa lafiya ba tare da cirrhosis ba." J Hepatol. 2017; 66 (Tada 1): S33.
> Cibiyar Abinci da Drug. "FDA ta amince da Mavyret ga Hepatitis C." Silver Spring, Maryland; bayar da Agusta 3, 2017.