Yini i-Abatacept: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Abatacept iyimithi kadokotela esiza ukuthulisa amasosha omzimba asebenza ngokweqile, ikakhulukazi kubantu abane-rheumatoid arthritis nezinye izifo ezizimele. Cabanga ngayo njengebheki elithambile le-immune system yakho uma ngempela ihlasela izicubu zakho ezinempilo.

Le mithi iza ngezindlela ezimbili: ukumnika ngomthambo (IV) okunikezwa endaweni yezokwelapha, kanye nemijovo engaphansi kwesikhumba ongazinika yona ekhaya. Zombili zisebenza ngendlela efanayo kodwa zinikeza amazinga ahlukene okulula ngokuya ngendlela yakho yokuphila nezidingo zezokwelapha.

Yini i-Abatacept?

I-Abatacept iyimithi ye-biologic eyingxenye yeqembu elibizwa ngokuthi ama-modulators okukhetha ukubambisana. Isebenza ngokuvimba izimpawu ezithile phakathi kwamaseli omzimba abangela ukuvuvukala nokulimala kwamalunga.

Ngokungafani nezinye izinto eziqinile zokucindezela amasosha omzimba, i-abatacept ithatha indlela eqondiswe kakhulu. Ayivali yonke i-immune system yakho kodwa kunalokho ilungisa izindlela ezithile ezinomthelela ezifweni ezizimele. Lokhu kuyenza ibe yindlela ethambile uma isasebenza.

Umuthi wenziwe ngamaprotheni futhi kufanele ugcinwe efrijini. Ivunyelwe yi-FDA kusukela ngo-2005 futhi isize izigidi zabantu ukuthi ziphathe izimo zabo ezizimele ngokunethezeka okwengeziwe.

Isetshenziselwani i-Abatacept?

I-Abatacept ikakhulukazi inikezwa i-rheumatoid arthritis kubantu abadala kanye nezingane ezineminyaka engaphezu kwengu-6 ubudala. Iphinde ivunywe i-psoriatic arthritis kanye ne-juvenile idiopathic arthritis.

Udokotela wakho angase ancome i-abatacept lapho ezinye izindlela zokwelapha zinganikezanga ukukhululeka okwanele, noma njengokwelashwa kokuqala ezimweni ezithile. Ilusizo ikakhulukazi kubantu abahlangabezana nokuqina okukhulu ekuseni, ukuvuvukala kwamalunga, nokukhathala okuvela esimweni sabo esizimele.

Abanye odokotela basebenzisa i-abatacept ngaphandle kwemvume yezinye izimo ze-autoimmune ezifana ne-lupus noma izinhlobo ezithile ze-vasculitis. Kodwa-ke, lokhu kuncike esimweni sakho esithile kanye nomlando wakho wezokwelapha.

Isebenza Kanjani I-Abatacept?

I-Abatacept isebenza ngokuvimba ukuxhumana okuthile phakathi kwamaseli omzimba okuthiwa ama-T-cells kanye namaseli abonisa i-antigen. Uma lawa maseli exhumana ngendlela engafanele, aqala ukuvuvukala okulimaza amalunga akho nezicubu.

Umuthi usebenza njengomgwebi omuhle, uvimbela lezi zingxoxo eziyingozi phakathi kwamaseli omzimba ngaphandle kokukhubaza ngokuphelele ikhono lomzimba wakho lokulwa nezifo. Le ndlela eqondiwe yingakho i-abatacept ithathwa njengomuthi onamandla aphakathi nendawo kunokuba i-immunosuppressant enamandla.

Ungase uqale ukuqaphela ukuthuthuka phakathi nezinyanga ezi-2-3, nakuba abanye abantu bebona izinzuzo ngokushesha. Imiphumela ephelele ivame ukuthuthuka ezinyangeni eziyi-6 njengoba umuthi unciphisa kancane kancane ukuvuvukala emzimbeni wakho wonke.

Kufanele Ngiyithathe Kanjani I-Abatacept?

Indlela othatha ngayo i-abatacept incike ohlotsheni udokotela wakho alubhala. Ukumnika nge-IV kunikezwa endaweni yezokwelapha ngaphezu kwemizuzu engaba ngu-30, kuyilapho imijovo engaphansi kwesikhumba ingenziwa ekhaya.

Ukwelashwa nge-IV, ngokuvamile uzothola ukumnika ngemuva kwamasonto ama-2, amasonto ama-4, bese kuba njalo ngemva kwamasonto ama-4 ngemva komthamo wakho wokuqala. Akudingeki ukuthi uzile ukudla ngaphambi kwesikhathi, kodwa ukuhlala unamanzi kahle kungakusiza ukuthi uzizwe ukhululekile ngesikhathi sokumnika.

Uma usebenzisa uhlobo olungaphansi kwesikhumba, uzolujova kanye ngesonto, ngokuvamile ethangeni lakho, esiswini, noma engalweni yakho engenhla. Ithimba lakho lezempilo lizokufundisa indlela efanele yokujova nokushintshanisa izindawo zokujova ukuvimbela ukucasuka.

Zombili izinhlobo zisebenza kahle ngokulinganayo, ngakho ukukhetha kuvame ukwehla ekuthandeni kwakho ukulula uma kuqhathaniswa nokuqinisekiswa kokuqashwa kwezokwelapha. Abanye abantu bakhetha imijovo yasekhaya yamasonto onke ukuze babe nezinto eziningi, kanti abanye bathanda ukuvakashelwa emtholampilo njalo ngenyanga ukuze baqhubeke nokugadwa.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Abatacept?

I-Abatacept ngokuvamile iyimithi yesikhathi eside, okusho ukuthi cishe uzoqhubeka nokuyithatha uma nje isiza isimo sakho futhi ingabangeli imiphumela emibi ebalulekile. Abantu abaningi bayithatha iminyaka kungezinyanga.

Udokotela wakho uzoqapha impendulo yakho njalo emavikini angu-3-6 ukuze ahlulele ukuthi imithi isasebenza ngempumelelo yini. Uma izimpawu zakho zilawulwa kahle futhi ungenayo imiphumela emibi, ukuqhubeka nokwelashwa ngokuvamile kunikeza imiphumela emihle kakhulu.

Abanye abantu bangase badinge ukuyeka okwesikhashana uma bethola izifo ezithile noma bedinga ukuhlinzwa. Udokotela wakho uzokuqondisa kunoma yikuphi ukuphumula okudingekayo futhi akusize ukuthi uqalise kabusha ngokuphepha uma kufanelekile.

Yini Imiphumela Eceleni Ye-Abatacept?

Abantu abaningi bayamukela kahle i-abatacept, kodwa njengayo yonke imithi, ingabangela imiphumela emibi. Ukuqonda ukuthi okulindelekile kungakusiza ukuthi uzizwe uqiniseka kakhulu ngokwelashwa kwakho.

Imiphumela emibi ejwayelekile ngokuvamile imnene futhi iyalawuleka. Lezi zindlela zansuku zonke zithinta abantu abaningi kodwa ngokuvamile azidingi ukuyeka imithi:

• Ukucasuka kwekhanda nokukhathala okuncane
• Izifo eziphezulu zokuphefumula njengomkhuhlane
• Ukucasuka kwesisu noma isicanucanu
• Ukuphendula kwendawo yokujova (ububomvu, ukuvuvukala, noma ubuhlungu obuncane)
• Isiyezi ngesikhathi noma ngemva kokufakwa kwe-IV

Le miphumela emibi ejwayelekile ivame ukuthuthuka njengoba umzimba wakho uzivumela emithini emasontweni ambalwa okuqala noma izinyanga.

Imiphumela emibi engathi sína ayivamile kodwa idinga ukunakekelwa kwezokwelapha ngokushesha. Nakuba kungavamile, lezi zimo zidinga ukuhlolwa okusheshayo:

• Izimpawu zokutheleleka okungathi sína (umkhuhlane, amaqhwa, ukukhwehlela okuqhubekayo, ukukhathala okungavamile)
• Ukuphendula okungathi sína komzimba (ubunzima bokuphefumula, ukuvuvukala, ukuqubuka okungathi sína)
• Ukuphuma kwegazi okungavamile noma ukulimala
• Isicanucanu esiqhubekayo, ukuhlanza, noma ubuhlungu besisu
• Izilonda zesikhumba ezintsha noma eziqhubekayo

Izindaba ezinhle ukuthi imiphumela emibi eyingozi yenzeka kubantu abangaphansi kuka-5% abathatha i-abatacept, futhi iningi lingalawulwa ngempumelelo uma itholwe kusenesikhathi.

Ubani Ongafanele Athatha I-Abatacept?

I-Abatacept ayilungile kuwo wonke umuntu, futhi izimo ezithile zempilo zenza ingafaneleki noma zidinga izinyathelo zokuphepha ezikhethekile. Udokotela wakho uzobukeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuyibhala.

Akufanele uthathe i-abatacept uma unokutheleleka okukhulu okusebenzayo, okuhlanganisa umkhuhlane wamathambo, noma uma uke waba nokusabela okukhulu komzimba emuthini ngaphambili. Abantu abanezinhlobo ezithile zomdlavuza bangase badinge ukuyigwema noma balinde kuze kube yilapho ukwelashwa kwabo kuqediwe.

Ukuqapha okukhethekile kuyadingeka uma unomlando wokutheleleka okuphindaphindayo, i-hepatitis B noma C, noma izimo ezithile zamaphaphu. Udokotela wakho cishe uzo-oda ezinye izivivinyo nokuqapha uma unezimo ezinjalo kodwa usadinga i-abatacept.

Abesifazane abakhulelwe noma abancelisa ngamabele kufanele baxoxe ngobungozi nezinzuzo ngokucophelela nodokotela wabo, njengoba imiphumela ezinganeni ezisakhulayo ingaqondakali ngokugcwele.

Amagama Omkhiqizo we-Abatacept

I-Abatacept ithengiswa ngaphansi kwegama lomkhiqizo elithi Orencia ngezinhlobo zombili ze-IV kanye ne-subcutaneous. Leli yigama elivamile ozolibona emiyalweni kanye nasezincwadini zomshuwalense.

Njengamanje azikho izinhlobo ezivamile ze-abatacept ezitholakalayo, njengoba kungumuthi oyinkimbinkimbi we-biologic okunzima ukuwulingisa ngqo. Kodwa-ke, izinhlobo ze-biosimilar zingase zitholakale esikhathini esizayo.

Ezinye izinkampani zomshuwalense zingase zidinge imvume yangaphambi kokuthi i-Orencia ngenxa yezindleko zayo, kodwa iningi labantu abanomkhuhlane wamathambo lingathola ukufakwa uma sekusungulwe isidingo sezokwelapha.

Ezinye Izindlela ze-Abatacept

Uma i-abatacept ingakulungele, eminye imithi eminingi ye-biologic isebenza ngendlela efanayo ezimweni ze-autoimmune. Lokhu kuhlanganisa i-adalimumab (Humira), i-etanercept (Enbrel), kanye ne-rituximab (Rituxan).

Imithi yendabuko yokuguqula izifo ze-antirheumatic (DMARDs) njenge-methotrexate noma i-sulfasalazine ivame ukuzanywa kuqala noma isetshenziswe ngokuhlangana nama-biologics. Le mithi inezindlela ezahlukene zokusebenza kanye namaphrofayili emiphumela emibi.

Udokotela wakho uzocabangela izinto ezinjengesimo sakho esithile, ezinye izinkinga zempilo, izintandokazi zokuphila, kanye nomshwalense lapho ekhetha enye indlela engcono kakhulu. Ngezinye izikhathi ukuzama omunye umuthi kungahlinzeka ngemiphumela engcono noma imiphumela emibi embalwa.

Ingabe i-Abatacept ingcono kune-Methotrexate?

I-Abatacept ne-methotrexate zisebenza ngendlela ehlukile futhi zivame ukusetshenziswa ndawonye kunokuba zibe ezinye izindlela zokuncintisana. I-Methotrexate ngokuvamile iyindlela yokwelapha yokuqala ye-rheumatoid arthritis, kuyilapho i-abatacept ivame ukwengezwa lapho i-methotrexate yodwa inganele.

I-Methotrexate ngumuthi omdala, oqashelwe kahle othathwa njengamaphilisi noma imijovo futhi obiza kakhulu kune-abatacept. Kodwa-ke, ingabangela ukuphazamiseka kwesisu okwengeziwe futhi idinga ukuqapha kwegazi njalo ukusebenza kwesibindi.

I-Abatacept ingase ibe ngcono kubantu abangakwazi ukubekezelela i-methotrexate noma abadinga ukulawulwa okwengeziwe kokuvuvukala. Abantu abaningi empeleni bathatha yomibili imithi ndawonye ukuze bathole imiphumela emihle, njengoba beqhubekisana nemiphumela yomunye nomunye.

Imibuzo Evame Ukubuzwa Mayelana ne-Abatacept

Ingabe i-Abatacept iphephile kubantu abanesifo sikashukela?

Yebo, i-abatacept ngokuvamile iphephile kubantu abanesifo sikashukela. Umuthi awuthinti ngokuqondile amazinga kashukela egazini noma uphazamisa imithi yesifo sikashukela.

Kodwa-ke, ukuba nesifo sikashukela kungakhuphula ingozi yakho yokutheleleka, futhi i-abatacept nayo ikhuphula kancane ingozi yokutheleleka. Udokotela wakho uzokuqapha eduze futhi angase ancome izinyathelo zokuphepha ezengeziwe njengokuhlolwa kashukela egazini njalo ngesikhathi sokugula.

Ngingenzani uma ngiphuthelwa ukusebenzisa i-Abatacept eningi kakhulu?

Uma ngempela uzijova i-abatacept eningi kunaleyo ebekiwe, xhumana nodokotela wakho noma usokhemisi ngokushesha. Nakuba ukweqisa kungavamile ngemijovo esivele igcwalisiwe, kubalulekile ukuthola isiqondiso sezokwelapha.

Ungazami ukulinganisa umthamo owengeziwe ngokweqa umjovo wakho olandelayo ohleliwe. Udokotela wakho uzokweluleka ngendlela ephephe kunazo zonke yokubuyela emgqeni ohleliwe wokulinganisa umthamo wakho ovamile.

Kufanele Ngenzeni Uma Ngiphuthelwa Umthamo We-Abatacept?

Uma uphuthelwa umjovo ongaphansi kwesikhumba, wuthatha ngokushesha lapho ukhumbula, bese ubuyela esimisweni sakho samasonto onke esivamile. Ungaphindi umthamo ukuze ulungise umjovo ophuthelwe.

Ngokufakwa kwe-IV, xhumana nehhovisi likadokotela wakho ukuze uhlele kabusha ngokushesha ngangokunokwenzeka. Bangase balungise ama-aphoyintimenti akho ambalwa alandelayo ukuze ubuyele esimisweni esifanele sokwelashwa kwakho.

Ngingayeka Nini Ukuthatha I-Abatacept?

Kufanele uyeke kuphela ukuthatha i-abatacept ngaphansi kokuqondisa kukadokotela wakho. Ukuyeka kungazelelwe kungaholela ekuqubukeni kwesimo sakho sokuzivikela emzimbeni emasontweni noma ezinyangeni.

Udokotela wakho angase ancome ukuyeka uma uthola imiphumela emibi engathi sína, ufinyelela ekuxolelweni kwesikhathi eside, noma udinga ukushintshela emuthini ohlukile. Bazokwenza uhlelo lokukuqapha eduze ngesikhathi sokuyeka ukwelashwa.

Ngingakwazi Ukuthola Imigomo Ngesikhathi Ngithatha I-Abatacept?

Imigomo eminingi ejwayelekile iphephile ngenkathi uthatha i-abatacept, kodwa kufanele ugweme imigomo ephilayo efana nesifutho somkhuhlane wamakhala noma umgomo we-shingles. Udokotela wakho uzoncoma ukuthi uthole umgomo womkhuhlane ojovwayo esikhundleni salokho.

Kuyinto ebalulekile ngempela ukuhlala unolwazi lwakamuva ngemigomo ngenkathi use-abatacept, njengoba umuthi ungenza ukuthi uthambekele ezifweni ezithile. Hlela ukuthola imigomo yakho uma uzizwa kahle futhi ungenazo izifo ezisebenzayo.