Icyo Ocrelizumab ari cyo: Ibikoreshwa, Uburyo bwo Gukoresha, Ingaruka Ziterwa n'Uko Ikora n'ibindi

Ocrelizumab ni umuti wandikirwa na muganga ufasha kugabanya indwara ya multiple sclerosis (MS) mu kwibasira uturemangingo twihariye tw'umubiri. Utangwa binyuze mu guterwa urushinge mu muvuduko (IV) kwa muganga cyangwa ikigo giterwa inshinge, akenshi buri mezi atandatu nyuma yo guterwa doze za mbere.

Uyu muti ugaragaza iterambere rikomeye mu kuvura MS, utanga icyizere ku bantu bafite ubwoko bwombi bwa relapsing na primary progressive bw'iyi ndwara. Kumva uko ikora n'icyo wakwitega birashobora kugufasha kumva ufite icyizere cyinshi ku rugendo rwawe rw'ubuvuzi.

Ocrelizumab ni iki?

Ocrelizumab ni umuti wa monoclonal antibody wibanda by'umwihariko ku turemangingo twa B mu mubiri wawe. Utu turemangingo twa B tugira uruhare runini mu buryo umubiri w'umuntu wivumbura ku bintu bitari ibyawo butuma imitsi y'ubwonko yangirika muri multiple sclerosis.

Tekereza nk'umuti ukora neza cyane ukora nk'igisasu kiyoborwa, gishakisha no kwifatanya na poroteyine zihariye zifite izina rya CD20 ku turemangingo twa B. Iyo kimaze kwifatanya, gifasha kugabanya umubare w'utu turemangingo dushobora gutera umuvumo mu mikoranire y'imitsi yawe.

Uyu muti ubarirwa mu cyiciro cyitwa disease-modifying therapies (DMTs), bivuze ko ntivura gusa ibimenyetso ahubwo ikora mu kugabanya iterambere rya MS ubwayo. Ibi bituma itandukana cyane n'imiti ifasha gusa ku bimenyetso byihariye nk'imitsi yikanyaga cyangwa umunaniro.

Ocrelizumab ikoreshwa ku iki?

Ocrelizumab yemewe na FDA mu kuvura ubwoko bubiri bw'ingenzi bwa multiple sclerosis. Niwo muti wa mbere kandi wenyine wemerewe kuvura primary progressive MS, ibi bituma uba ingirakamaro cyane ku bantu bafite ubu bwoko bw'iyi ndwara.

Ku bwoko bwa relapsing bwa MS, ibi birimo relapsing-remitting MS na active secondary progressive MS. Ubu nibwo bwoko abantu bahuriramo n'ibitero bigaragara cyangwa relapses bikurikirwa n'ibihe byo koroherwa cyangwa guhagarara.

Umuti wa ocrelizumab ushobora gushyirwaho na muganga wawe niba utarabyitwayemo neza ku zindi miti ivura MS, cyangwa niba ufite MS ikomeza yambere aho izindi nzira zitarimo. Rimwe na rimwe kandi, uhitwamo nk'umuti wa mbere ku bantu bafite MS ikora cyane igaruka.

Umuti wa Ocrelizumab ukora ute?

Ocrelizumab ikora igabanya selile za B, ari selile zikingira zigira uruhare mu gutwika mu gihe cya MS. Ibi bifatwa nk'inzira ikomeye yo kuvura MS, ikomeye kurusha imiti imwe yo kunywa ariko idafite uburebure nk'izindi nzira zo guterwa imiti.

Umuti wifatanya na poroteyine za CD20 ku ruhu rwa selile za B, ukazishyira ahagaragara kugira ngo zisenywe n'ubwirinzi bwawe. Iyi nzira igabanya cyane umubare wa selile za B zizenguruka mu mubiri wawe mu gihe cy'amezi menshi.

Igituma iyi nzira ikora neza cyane ni uko yibanda ku selile zikingira zifite uruhare runini mu iterambere rya MS mu gihe isiga ibindi bice by'ubwirinzi bwawe bitameze neza. Kugabanya selile za B mubisanzwe bimara amezi menshi, niyo mpamvu umuti utangwa buri mezi atandatu.

Muri iki gihe gito cyo kuvurwa, uzagira selile za B nkeya cyane mu mubiri wawe. Nyuma y'igihe, izi selile zigaruka buhoro buhoro, ariko ingaruka z'umuti ku kugabanya iterambere rya MS zirashobora gukomeza nubwo umubare wa selile za B ugaruka.

Nkwiriye gufata Ocrelizumab nte?

Ocrelizumab itangwa gusa binyuze mu guterwa imiti muri IV ahantu havurirwa, ntabwo itangwa mu rugo. Urutonde rwawe rwa mbere mubisanzwe rugabanyijemo ibice bibiri bitangwa nyuma y'ibyumweru bibiri, buri gice gifata amasaha agera kuri 2.5 kugeza kuri 3.5.

Mbere yo guterwa buri gice, uzahabwa imiti mbere yo guterwa kugira ngo ifashe kwirinda ibikorwa byo guterwa. Ibi mubisanzwe birimo antihistamine nka diphenhydramine, corticosteroid nka methylprednisolone, rimwe na rimwe acetaminophen. Iyi miti ifasha umubiri wawe kwihanganira guterwa neza.

Ntabwo ukeneye gufata ocrelizumab hamwe n'ibiryo kuko itangwa mu maraso yawe. Ariko, kurya ifunguro rito mbere yo gufata urukingo rwawe birashobora kugufasha kumva umeze neza mugihe cyo gukora iki gikorwa kirekire.

Mugihe cyo gufata urukingo, abakozi b'ubuvuzi bazagukurikiranira hafi kugirango barebe niba hari icyo wumva. Umuti utangwa buhoro buhoro mbere na mbere, hanyuma umuvuduko urashobora kwiyongera niba ubasha kuwihanganira neza. Abantu benshi barashobora gusoma, gukoresha terefone zabo, cyangwa no gusinzira mugihe cyo gufata urukingo.

Nzamara Igihe Kingana Gite Ndafataga Ocrelizumab?

Ocrelizumab mubisanzwe ni uburyo bwo kuvura burambye uzakomeza mugihe cyose bifasha MS yawe kandi ukaba ubasha kubyihanganira neza. Abantu benshi bakoresha uyu muti imyaka myinshi, hamwe no gukurikiranwa buri gihe kugirango barebe ko bikomeza kuba byiza kandi bikora neza.

Muganga wawe azasuzuma uko witwara mugihe uvurwa buri mezi atandatu, mubisanzwe mugihe cyo gufata urukingo rwawe rutaha. Bazareba ibintu nk'ibisubizo bishya, impinduka za MRI, iterambere ry'ubumuga, n'ingaruka zose zikubaho.

Abantu bamwe bashobora gukenera guhagarika ocrelizumab niba bagize indwara zikomeye, kanseri zimwe na zimwe, cyangwa ibisubizo bikomeye byo gufata urukingo. Muganga wawe azaganira nawe kuri ibyo byago kandi akurikirane ibimenyetso byose byerekana ko umuti ugomba guhagarikwa.

Umwanzuro wo gukomeza cyangwa guhagarika ocrelizumab ugomba gufatwa buri gihe hamwe n'inzobere yawe ya MS, ugipima inyungu urimo kubona ugereranije n'ibibazo cyangwa ingaruka zikubaho.

Ni Iyihe Miterere Y'ingaruka za Ocrelizumab?

Kimwe n'imiti yose, ocrelizumab irashobora gutera ingaruka, nubwo abantu benshi babasha kuyihanganira neza. Ingaruka zisanzwe ni izijyanye n'inzira yo gufata urukingo no kongera ubushobozi bwo kwandura indwara.

Hano hari ingaruka zivugwa kenshi ushobora guhura nazo:

• Uko guhinduka kw'uruhu, gushishimuka, cyangwa umuriro muke mugihe cyangwa nyuma gato yo kuvurwa
• Uburwayi bwo mu nzira yo hejuru yo mu myuka nka ibicurane cyangwa indwara zo mu mazuru
• Uburwayi bwo ku ruhu cyangwa ibibazo bya herpes yo mu kanwa
• Umunaniro ushobora kumara iminsi mike nyuma yo guterwa urushinge
• Umutwe cyangwa kubabara umubiri bike
• Isesemi cyangwa guhinduka mu igogora

Ibi bibazo bisanzwe biterwa n'imiti mubisanzwe birashoboka kubicunga kandi akenshi birakosoka uko umubiri wawe wimenyereza umuti.

Ingaruka zikomeye ariko zitabaho kenshi zisaba ubufasha bwihuse bw'abaganga kandi zirimo:

• Uko guhinduka gukomeye hamwe no guhumeka bigoye, kubyimba bikabije, cyangwa kubabara mu gituza
• Ibimenyetso by'indwara zikomeye nka umuriro udakira, umunaniro ukabije, cyangwa ibimenyetso bidasanzwe
• Progressive multifocal leukoencephalopathy (PML), indwara idasanzwe yo mu bwonko
• Gusubira mu bikorwa kwa hepatite B mu bantu bari barayirwaye mbere
• Ubwoko bumwe na bumwe bwa kanseri, cyane cyane kanseri y'ibere

Itsinda ryawe ry'ubuvuzi rizagukurikiranira hafi ibi bibazo bidasanzwe ariko bikomeye binyuze mu bipimo by'amaraso bisanzwe no kugenzura.

Ninde utagomba gufata Ocrelizumab?

Ocrelizumab ntabwo ikwiriye kuri buri wese ufite MS. Muganga wawe azasuzuma neza amateka yawe y'ubuvuzi kugirango amenye niba uyu muti ari mwiza kuri wowe.

Ntabwo ugomba gufata ocrelizumab niba ufite indwara ya hepatite B ikora, kuko uyu muti ushobora gutuma iyi virusi yongera gukora mu buryo bukomeye. Uzakenera ibizamini by'amaraso kugirango urebe hepatite B mbere yo gutangira kuvurwa.

Abantu bafite indwara zikomeye zikora bagomba gutegereza kugeza zivuwe neza mbere yo gutangira ocrelizumab. Ibi birimo indwara ziterwa na bagiteri, virusi, cyangwa imyungu ishobora kuzamba iyo ubudahangarwa bwawe buhagaritswe.

Niba waragize ibibazo bikomeye byo kwivumbura ku ocrelizumab cyangwa imiti isa nayo mu bihe byashize, ubu buvuzi ntibusabwa. Muganga wawe azaganira ku zindi nzira zishobora kuba zikurinda.

Abagore batwite ntibagomba guhabwa ocrelizumab, kuko bishobora gushyira mu kaga umwana ukiri mu nda. Niba uteganya gutwita, ganira ibi na muganga wawe mbere y'igihe, kuko uyu muti ushobora kugira ingaruka ku mikorere y'umubiri wawe w'ubudahangarwa mu mezi menshi nyuma ya doze yawe ya nyuma.

Amazina y'ubwoko bwa Ocrelizumab

Ocrelizumab igurishwa ku izina ry'ubwoko rya Ocrevus muri Leta Zunze Ubumwe z'Amerika no mu bindi bihugu byinshi. Iri ni ryo zina ry'ubwoko ririho ubu, kuko nta bwoko bwa generic bw'uyu muti buraboneka.

Ocrevus ikorwa na Genentech muri Amerika na Roche mu bindi bihugu. Zombi ni iz'itsinda rimwe ry'imiti, bityo uyu muti usa neza aho wakorewe hose.

Igihe uvugana n'abaganga cyangwa amasosiyete y'ubwishingizi ku bijyanye n'ubuvuzi bwawe, ushobora kumva amazina yombi akoreshwa mu buryo busimburana. Abaganga bamwe bakunda gukoresha izina rya generic (ocrelizumab) mu gihe abandi bakoresha izina ry'ubwoko (Ocrevus).

Uburyo bwo gusimbura Ocrelizumab

Imiti myinshi ishobora kuvura MS, nubwo guhitamo neza biterwa n'ubwoko bwawe bwa MS n'imimerere yawe bwite. Muganga wawe azagufasha gupima ibyiza n'ibibi bya buri kimwe.

Kubera MS isubiramo, ibisubizo birimo imiti yo kunywa nka fingolimod (Gilenya), dimethyl fumarate (Tecfidera), cyangwa teriflunomide (Aubagio). Iyi miti akenshi yoroshye gufata ariko ishobora kuba idakora neza ku ndwara ikora cyane.

Ubuvuzi bundi bwo guterwa ni natalizumab (Tysabri) na alemtuzumab (Lemtrada), byombi bikora mu buryo butandukanye na ocrelizumab. Natalizumab itangwa buri kwezi, mu gihe alemtuzumab ikubiyemo uburyo bubiri bwo kuvura mu mwaka umwe.

Ku bijyanye na MS ikomeza kwiyongera, ocrelizumab ubu ni wo muti wemewe na FDA gusa, bigatuma uba wo ku isonga muri ubu bwoko bw'indwara. Ariko, abaganga bamwe bashobora gutekereza gukoresha imiti itandukanye mu bihe byihariye.

Ese Ocrelizumab iruta Rituximab?

Ocrelizumab na rituximab ni imiti isa yombi igamije selile za B, ariko ocrelizumab yagenewe by'umwihariko kandi yemerewe kuvura MS. Rituximab ikoreshwa cyane cyane mu kuvura kanseri zimwe na zimwe n'indwara ziterwa n'ubwirinzi bw'umubiri, nubwo abaganga bamwe bayikoresha mu buryo butemewe mu kuvura MS.

Ocrelizumab ifatwa nk'iyateye imbere kurusha rituximab, ifite impinduka zituma ishobora kuba itekanye kandi ifite akamaro kurushaho mu kuvura MS. Yagenewe kugabanya ubwirinzi bw'umubiri, bivuze ko umubiri wawe udashobora gukora imisemburo irwanya yo.

Amakuru y'igeragezwa rya ocrelizumab muri MS arambuye cyane kurusha aya rituximab, aha abaganga amakuru meza yerekeye imikorere yayo n'umutekano wayo. Ibi bituma ocrelizumab ihitamo ryiza ku bahanga benshi muri MS.

Ariko, rituximab ishobora gukoreshwa rimwe na rimwe niba ocrelizumab itaboneka cyangwa itishyurwa n'ubwishingizi, kuko iyo miti yombi ikora mu buryo busa cyane. Muganga wawe ashobora kugufasha gusobanukirwa uburyo bwiza bushobora kuba bwiza ku miterere yawe yihariye.

Ibibazo Bikunze Kubazwa Kuri Ocrelizumab

Ese Ocrelizumab irakwiriye ku bantu barwaye indwara z'umutima?

Ocrelizumab muri rusange irashobora gukoreshwa mu buryo butekanye ku bantu barwaye indwara z'umutima, ariko umuganga w'umutima wawe n'umuganga w'imitsi bazagomba guhuza ubuvuzi bwawe. Ikibazo gikomeye ni uko ibisubizo byo guterwa imiti bishobora gushyira umutima wawe mu kaga.

Mbere yo gutangira kuvurwa, muganga wawe azasuzuma uko umutima wawe umeze kandi ashobora kugusaba gukurikiranwa by'inyongera mu gihe cyo guterwa imiti. Abantu bamwe bafite ibibazo bikomeye by'umutima bashobora gukenera guterwa imiti gahoro cyangwa mu bitaro aho gutererwa mu kigo cy'ubuvuzi bw'abarwayi batari mu bitaro.

Nkwiri Kora Iki Niba Ntabiteweho Urukingo rwa Ocrelizumab?

Vugana n'ibiro bya muganga wawe ako kanya umenye ko utabonye igihe cyagenwe cyo guterwa urukingo. Bazagufasha kongera gutegura vuba bishoboka, byaba byiza mu byumweru bike nyuma y'itariki wari uteganyirijweho.

Kutabona urukingo bishobora kugabanya imikorere y'umuti kandi bishobora gutuma ibikorwa bya MS bigaruka. Ariko, ntugahagarike umutima niba utabonye igihe cyagenwe kubera uburwayi cyangwa izindi mpamvu. Itsinda ryawe ry'ubuvuzi rizakorana nawe kugira ngo ugaruke mu nzira neza.

Nkwiri Kora Iki Niba Ngize Ibyiyumvo Bikomeye Mugihe Naterwa Urukingo?

Bwira umuforomo wawe uhita aterwa urukingo niba ubonye ibimenyetso bibangamiye mugihe uvurwa. Ibimenyetso bisanzwe byo guterwa urukingo birimo uruhu rwijimye, kuribwa, guhumeka bigoye, guhagarara mu gituza, cyangwa kumva umeze nk'uwenda guta umutwe.

Abakozi b'ubuvuzi bahawe imyitozo yo guhangana n'ibi bihe kandi birashoboka ko bazatinda cyangwa bahagarike urukingo, bakuguhe imiti yinyongera, kandi bakugenzure neza. Ibimenyetso byinshi byo guterwa urukingo birashobora gucungwa kandi ntibizabuza kurangiza kuvurwa, nubwo bishobora gutwara igihe kirekire.

Nshobora Guhagarika Ryari Gufata Ocrelizumab?

Umwanzuro wo guhagarika ocrelizumab ugomba gufatwa buri gihe hamwe n'inzobere yawe ya MS, ntabwo ari wowe ubwawe. Nta gihe giteganijwe cyo kuvurwa, kuko abantu benshi bungukira mu kuguma ku muti igihe kirekire.

Muganga wawe ashobora kugusaba guhagarika niba ugize ingaruka zikomeye, niba MS yawe idakora igihe kirekire, cyangwa niba ukeneye gutangira umuryango. Bazagufasha gupima ibyago n'inyungu byo gukomeza cyangwa guhagarika kuvurwa.

Nshobora Kubona Urukingo Ngihe Ndafata Ocrelizumab?

Urashobora guhabwa inkingo nyinshi mugihe ufata ocrelizumab, ariko zirashobora kutagira akamaro kuko ubudahangarwa bwawe buhagaritswe. Muganga wawe azagusaba kurangiza inkingo zose zikenewe mbere yo gutangira kuvurwa niba bishoboka.

Inkingo zikoresha virusi zikiri nzima zigomba kwirindwa igihe uri gukoresha ocrelizumab, kuko zishobora gutera indwara. Ibi bikubiyemo inkingo nk'urukingo rwa grippe rukoresha virusi ikiri nzima, MMR, na varicella (chickenpox). Ariko, inkingo zitagira ubuzima nk'urukingo rusanzwe rwa grippe muri rusange ni nziza kandi zirashimwa.