Yini i-Belimumab: Ukusetshenziswa, Umthamo, Imiphumela Eceleni Nokunye

I-Belimumab iyimithi kadokotela esiza ukuthulisa amasosha akho omzimba adlulele lapho ngamaphutha ehlasela umzimba wakho. Yenzelwe ngqo ukwelapha izimo ze-autoimmune ezifana ne-lupus, lapho amasosha akho omzimba edinga isiqondiso esithambile ukuze ayeke ukukulwa.

Le mithi isebenza ngokuvimba iphrotheni ebizwa nge-BLyS (B-lymphocyte stimulator) etshela amasosha athile omzimba ukuthi abe namandla ngokweqile. Cabanga ngayo njengokwehlisa ivolumu kumasosha omzimba abelokhu edlala ngokuzwakalayo.

Yini i-Belimumab Esetshenziselwa Yona?

I-Belimumab isetshenziselwa ikakhulukazi ukwelapha i-systemic lupus erythematosus (SLE), eyaziwa ngokuthi i-lupus. Udokotela wakho angase akubhalele uma une-lupus esebenzayo engaphendulanga kahle ngokwanele ekwelashweni okujwayelekile okufana nama-antimalarials, ama-corticosteroids, noma ama-immunosuppressants.

Lo muthi uvunyelwe futhi ukwelapha i-lupus nephritis, okwenzeka lapho i-lupus ithinta izinso zakho. Lolu uhlobo olungathi sína lwe-lupus oludinga ukuphathwa ngokucophelela ukuvikela ukusebenza kwezinso zakho.

Ngaphezu kwalokho, i-belimumab ingasiza nge-systemic lupus erythematosus esebenzayo ezinganeni ezineminyaka engu-5 nangaphezulu. Udokotela wakho uzoqaphela ngokucophelela izinzuzo nezingozi ngaphambi kokuyincoma ezigulini ezincane.

Isebenza Kanjani i-Belimumab?

I-Belimumab isebenza ngokugxila kuma-B-cells, okuyizinhlayiya zamasosha omzimba akhiqiza ama-antibody. Ku-lupus, la ma-B-cells aba namandla ngokweqile futhi akhe ama-antibody ahlasele izicubu zakho ezinempilo esikhundleni sokukuvikela ezifweni.

Lo muthi uvimba i-BLyS, iphrotheni esebenza njengamafutha ala ma-B-cells adlulele. Ngokunciphisa lo mthombo wamafutha, i-belimumab isiza ukunciphisa inani lama-B-cells anezinkinga ohlelweni lwakho, okunganciphisa izimpawu ze-lupus nokuqubuka.

Lokhu kubhekwa njengokwelashwa okuqondiwe kunokuba kube yi-immunosuppressant ebanzi, okusho ukuthi kunembile kakhulu endleleni okuthinta ngayo amasosha akho omzimba. Kodwa-ke, iseyithuthukisi eliqinile elidinga ukuqashwa ngokucophelela yithimba lakho lezempilo.

Kufanele Ngiyithathe Kanjani I-Belimumab?

I-Belimumab iza ngezindlela ezimbili: ukumnika ngomthambo (IV) kanye nomjovo ongaphansi kwesikhumba (ngaphansi kwesikhumba). Udokotela wakho uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe ngokusekelwe esimweni sakho esithile nezidingo zokuphila kwakho.

Ukuze uthole ukumnika kwe-IV, uzothola umuthi endaweni yokunakekelwa kwezempilo njalo emavikini amane. Ukumnika kuvame ukuthatha cishe ihora elilodwa, futhi uzoqashwa ngesikhathi nangemva kokwelashwa nganoma yiziphi izindlela eziphuthumayo.

Uma usebenzisa uhlobo olungaphansi kwesikhumba, cishe uzolujova kanye ngesonto ekhaya ngemva kokuqeqeshwa okufanele. Ithimba lakho lezempilo lizokufundisa indlela efanele yokujova futhi likusize uzizwe ukhululekile ngale nqubo.

Awudingi ukuthatha i-belimumab ngokudla, kodwa kubalulekile ukugcina isimiso esiqhubekayo. Abanye abantu bakuthola kuwusizo ukumaka ikhalenda labo noma ukusetha izikhumbuzi zocingo ukuze bahlale emgwaqeni.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Belimumab?

I-Belimumab ngokuvamile iyindlela yokwelapha yesikhathi eside ozoqhubeka nayo uma nje isiza i-lupus yakho futhi uyayibekezelela kahle. Abantu abaningi bayayithatha iminyaka eminingi ukuze balawule izimpawu zabo futhi bavimbele ukuqubuka.

Ungase uqale ukuqaphela ukuthuthuka ngemva kwezinyanga ezimbalwa, nakuba kungase kuthathe izinyanga eziyisithupha ukubona izinzuzo ezigcwele. Lokhu kuthuthuka kancane kancane kwenzeka ngoba i-belimumab isebenza ngokunciphisa kancane amangqamuzana omzimba asebenzayo kunokunikeza ukukhululeka ngokushesha.

Udokotela wakho uzohlola njalo ukuthi umuthi usebenza kahle kangakanani ngokusebenzisa ukuhlolwa kwegazi, ukuqapha izimpawu, nokuhlola noma yiziphi izinto ezingezinhle. Bazokusiza ukuthi unqume ukuthi kufanelekile nini ukuqhubeka, ukulungisa, noma ukuyeka ukwelashwa.

Yiziphi Izinto Ezingezinhle Ze-Belimumab?

Njengazo zonke izidakamizwa ezithinta amasosha omzimba wakho, i-belimumab ingabangela imiphumela emibi, nakuba kungewona wonke umuntu oyitholayo. Ukuqaphela ukuthi yini okufanele uyibheke kukusiza ukuthi uhlale uphephile futhi uthole ukunakekelwa ngokushesha uma kudingeka.

Imiphumela emibi evame kakhulu ongase uyithole ihlanganisa isicanucanu, isifo sohudo, umkhuhlane, ikhala elivaliwe, i-bronchitis, ukuqwasha, nobuhlungu ezingalweni noma emilenzeni yakho. Lezi zimpawu zivame ukuba mnene futhi zivame ukuthuthuka njengoba umzimba wakho ujwayela umuthi.

Imiphumela emibi engathi sína kodwa engavamile ingahlanganisa:

• Ukwanda kwengozi yokutheleleka ngenxa yokucindezelwa kwamasosha omzimba
• Ukuphendula komzimba okunamandla, ikakhulukazi ngesikhathi sokufakwa kwe-IV
• Ukucindezeleka noma izinguquko zemizwa
• Ukutheleleka okungathi sína okungase kudingeke ukuthi umuntu alaliswe esibhedlela

Ngenxa yokuthi i-belimumab ithinta amasosha omzimba wakho, uzoba nengozi enkulu yokuthola izifo. Lokhu kusho ukuthi kufanele uthinte udokotela wakho uma uba nomkhuhlane, izimpawu ezinjengomkhuhlane, noma yiziphi izimpawu zokutheleleka.

Imiphumela emibi engavamile kodwa engathi sína ihlanganisa ukucindezeleka okukhulu, imicabango yokuzilimaza, i-progressive multifocal leukoencephalopathy (PML), kanye nokuvuselelwa kwe-hepatitis B kubantu abake baba nalolu hlobo lokutheleleka.

Ubani Ongafanele Athole I-Belimumab?

I-Belimumab ayilungile kuwo wonke umuntu, futhi udokotela wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuyinika. Akufanele uthathe lo muthi uma wake waba nokuphendula komzimba okukhulu ku-belimumab noma kunoma yiziphi izithako zawo esikhathini esidlule.

Abantu abanezifo eziqhubekayo, ezinzima kufanele balinde kuze kube yilapho ukutheleleka kuphathwe ngokugcwele ngaphambi kokuqala i-belimumab. Lokhu kuhlanganisa izifo ezinzima zamagciwane, amagciwane, isikhunta, noma ezinye izifo ezingase zibe zimbi ngokucindezelwa kwamasosha omzimba.

Udokotela wakho uzoba nokuqapha okukhethekile uma une:

• Umlando wokutheleleka okungamahlalakhona noma ukutheleleka okuvamile
• I-HIV, i-hepatitis B, noma i-hepatitis C
• Umlando wokucindezeleka noma imicabango yokuzibulala
• Umkhuhlane wangaphambilini noma ukwelashwa komkhuhlane kwamanje
• Izinhlelo zokuthola imithi yokugoma ephilayo

Uma ukhulelwe noma uhlela ukukhulelwa, uzodinga ukuxoxa ngobungozi nezinzuzo nodokotela wakho. I-Belimumab ingawela i-placenta futhi ingase ithinte amasosha omzimba enganeni yakho esakhula.

Amagama Omkhiqizo we-Belimumab

I-Belimumab itholakala ngaphansi kwegama lomkhiqizo elithi Benlysta. Leli yilo kuphela igama lomkhiqizo elitholakala njengamanje lolu hlobo lomuthi, olukhiqizwa yi-GSK (GlaxoSmithKline).

Noma ngabe uthola ifomu le-IV noma elingaphansi kwesikhumba, kokubili kuthengiswa ngaphansi kwegama lomkhiqizo elifanayo elithi Benlysta. Umuthi wakho ozonqunywa uzocacisa ukuthi yiluphi uhlobo namandla owadingayo.

Ezinye Izindlela Zokwelapha ze-Belimumab

Uma i-belimumab ingakulungele noma inganikezi ukulawula okwanele kwe-lupus yakho, kunezindlela eziningi zokwelapha ezitholakalayo. Udokotela wakho angase acabange ngeminye imithi ye-biologic efana ne-rituximab, nayo eqondise amaseli e-B kodwa isebenza ngendlela ehlukile.

Imithi yendabuko ecindezela amasosha omzimba isabalulekile, okuhlanganisa i-methotrexate, i-mycophenolate, i-azathioprine, ne-cyclophosphamide. Le mithi inemlando omude futhi ingase ifaneleke kakhulu ezimweni ezithile.

Ukwelashwa okusha njenge-anifrolumab (Saphnelo) kunikeza enye indlela eqondiwe yokwelapha i-lupus. Udokotela wakho uzocabangela izinto ezinjengezimpawu zakho ezithile, ukwelashwa kwangaphambilini, nempilo yonke lapho ekhetha inketho engcono kakhulu kuwe.

Ngezinye izikhathi, ukwelashwa okuhlanganisiwe ngama-antimalarials afana ne-hydroxychloroquine noma ukuphathwa ngokucophelela kwe-corticosteroid kungase kufaneleke kakhulu kunokushintshela emithini ehlukile ye-biologic.

Ingabe i-Belimumab Ingcono Kune-Rituximab?

Ukuqhathanisa i-belimumab ne-rituximab akulula ngoba zisebenza ngendlela ehlukile futhi zisetshenziswa ezimweni ezingafani. Zombili ziqondise amaseli e-B, kodwa i-rituximab inciphisa la maseli ngokuphelele kanti i-belimumab inciphisa ukusebenza kwawo kancane kancane.

I-Belimumab inemininingwane eminingi yezivivinyo zomtholampilo ngokuqondile ekwelapheni i-lupus, ngemvume ye-FDA esekelwe ezifundweni ezinkulu, ezihlelekile. I-Rituximab, nakuba isebenza kahle ezigulini eziningi ze-lupus, isetshenziswa "ngaphandle kwelebula" kulesi simo.

Ukukhetha phakathi kwale mithi kuncike esimweni sakho esithile, okuhlanganisa ukuthi i-lupus yakho inobukhulu obungakanani, ukuthi yiziphi izitho ezithintekile, nokuthi usabele kanjani ekwelashweni kwangaphambilini. Udokotela wakho uzocabangela izici zakho ngazinye kunokumemezela eyodwa "engcono" ngokujwayelekile.

Abanye abantu benza kahle ngendlela ethambile, eqhubekayo ye-belimumab, kanti abanye badinga ukuncipha kwamaseli e-B okukhulu kwe-rituximab. Zombili lezi zithako zidinga ukuqapha ngokucophelela futhi zinezinhlobo zazo ezihlukile zemiphumela emibi.

Imibuzo Evame Ukubuzwa Mayelana ne-Belimumab

Ingabe i-Belimumab iphephile kubantu abanezifo zezinso?

I-Belimumab empeleni ivunyelwe ukwelapha i-lupus nephritis, okuyilapho izinso zihileleka ku-lupus. Kodwa-ke, uma unezifo ezinzima zezinso ezibangelwa ezinye izimbangela, udokotela wakho uzodinga ukuhlola ngokucophelela ukuthi i-belimumab ilungele yini wena.

Umuthi ukhishwa ngokuyinhloko ngezindlela zomzimba zakho zokuhlukanisa amaprotheni kunokuba ngokususa izinso, ngakho izinkinga zezinso ezilula kuya kweziphakathi nendawo ngokuvamile azidingi ukulungiswa komthamo. Udokotela wakho uzoqapha ukusebenza kwezinso zakho njalo.

Ngingenzani uma ngizifaka i-Belimumab eningi ngengozi?

Uma ngengozi uzifaka i-belimumab engaphansi kwesikhumba eningi kunaleyo ebekiwe, xhumana nodokotela wakho noma umhlinzeki wezempilo ngokushesha. Nakuba kungekho umuthi oqondile wokweqisa i-belimumab, bazofuna ukukuqapha eduze ukuze uthole imiphumela emibi.

Ngemithamo ye-IV, ukweqisa kulindeleke kancane njengoba ochwepheshe bezempilo bephatha imithi. Kodwa-ke, uma usola ukuthi kukhona iphutha elenzekile ngesikhathi sokufakwa kwakho, yazisa ithimba lakho lezempilo ngokushesha ukuze bakwazi ukuthatha izinyathelo ezifanele zokubheka.

Kufanele ngenzeni uma ngiphuthelwa umthamo we-Belimumab?

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

Ngemithamo ye-IV, xhumana nomhlinzeki wakho wezempilo ukuze uhlele kabusha ngokushesha ngangokunokwenzeka. Zama ukugcina isikhawu samasonto amane phakathi kwemithamo, kodwa ungakhathazeki uma udinga ukulungisa ngosuku olumbalwa ngenxa yezinkinga zokuhlela.

Ngingayeka nini ukuthatha i-Belimumab?

Ungalokothi uyeke ukuthatha i-belimumab ngaphandle kokuxoxa ngakho nodokotela wakho kuqala. Ukuyeka kungazelelwe kungaholela ekuqubukeni kwe-lupus noma ekubhebhethekeni kwezimpawu zakho, njengoba imiphumela yokuvikela yomuthi iphela kancane kancane.

Udokotela wakho angase acabange ukuyeka i-belimumab uma usufeze ukuxolelwa okuzinzile isikhathi eside, uma uhlangabezana nemiphumela engathandeki, noma uma umuthi unganikezi inzuzo eyanele. Bazokusiza ukuthi udlulele ngokuphepha kwezinye izindlela zokwelapha uma kudingeka.

Ngingakwazi yini ukuthola imithi yokugoma ngenkathi ngithatha i-Belimumab?

Kufanele ugweme imithi yokugoma ephilayo ngenkathi uthatha i-belimumab, njengoba ingase ibangele izifo kubantu abanezinhlelo zokuzivikela ezicindezelwe. Lokhu kufaka phakathi imithi yokugoma efana ne-MMR, i-varicella (izinkukhu), kanye nemithi yokugoma umkhuhlane ngamakhala.

Imithi yokugoma engasebenzi (njengomjovo womkhuhlane, imithi yokugoma i-COVID-19, kanye nomuthi wokugoma umkhuhlane wamaphaphu) ngokuvamile iphephile futhi iyatuswa. Kodwa-ke, kungenzeka ingasebenzi kahle ngenkathi uthatha i-belimumab, ngakho-ke xoxa ngesikhathi kanye nokulindela nodokotela wakho.