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

I-Inclisiran uhlobo olusha lomuthi wokwehlisa i-cholesterol osebenza ngendlela ehlukile kunama-statins esintu. Inikezwa njengomjovo ngaphansi kwesikhumba sakho kabili ngonyaka ngumhlinzeki wakho wezempilo, okwenza kube yindlela elula kubantu abadinga usizo olwengeziwe lokuphatha amazinga abo e-cholesterol.

Lo muthi ungowesigaba esibizwa ngokuthi ama-PCSK9 inhibitors, avimba iphrotheni evimbela isibindi sakho ukuthi singasusi i-cholesterol embi egazini lakho. Cabanga ngakho njengokunikeza isibindi sakho isandla sokusiza ukwenza umsebenzi waso wokuhlanza i-cholesterol ngempumelelo.

Yini i-Inclisiran?

I-Inclisiran ngumuthi kadokotela oklanyelwe ukwehlisa i-LDL cholesterol, evame ukubizwa ngokuthi i-cholesterol "embi". Isebenzisa ubuchwepheshe obubizwa ngokuthi i-small interfering RNA (siRNA) ukunciphisa ukukhiqizwa kwe-cholesterol esibindini sakho.

Ngokungafani namaphilisi ansuku zonke, i-inclisiran inikezwa njengomjovo ongaphansi kwesikhumba njalo ezinyangeni eziyisithupha ngemva kwemithamo yakho yokuqala. Udokotela wakho noma umhlengikazi uzokunikeza le mithi emtholampilo wabo, ngokuvamile engalweni yakho engenhla, ethangeni, noma esiswini.

Lo muthi wagunyazwa yi-FDA ngonyaka ka-2021 futhi umelele intuthuko enkulu ekuphathweni kwe-cholesterol. Ilusizo ikakhulukazi kubantu abangazange bazifinyelele izinhloso zabo ze-cholesterol ngeminye imithi noma labo abanobunzima ekuthathweni kwemithi yansuku zonke.

Isetshenziselwani i-Inclisiran?

I-Inclisiran inikezwa kubantu abadala abane-cholesterol ephezulu abadinga usizo olwengeziwe ngaphandle kokudla nokuzivivinya. Yenzelwe ngqo abantu abanalesi sifo senhliziyo nemithambo yegazi ye-atherosclerotic noma i-hypercholesterolemia yomndeni.

Udokotela wakho angase akuncomele i-inclisiran uma usuvele uthatha i-statin kodwa usenawo amazinga aphezulu e-LDL cholesterol. Kungaba futhi enye indlela uma ungakwazi ukubekezelela ama-statins ngenxa yemiphumela emibi efana nobuhlungu bemisipha noma izinkinga zesibindi.

Umuthi ubaluleke kakhulu kubantu abane-familial hypercholesterolemia, isimo sezakhi zofuzo esibangela amazinga aphezulu kakhulu e-cholesterol kusukela ekuzalweni. Laba bantu bavame ukudinga imithi eminingi ukuze balawule i-cholesterol yabo ngempumelelo.

I-Inclisiran ihlala isetshenziswa kanye nokudla okunempilo kanye nezinguquko zokuphila. Akuyona indawo yokudla kahle nokuhlala usebenza, kodwa iyithuluzi elengeziwe lokukusiza ukuthi ufinyelele imigomo yakho ye-cholesterol.

Isebenza Kanjani I-Inclisiran?

I-Inclisiran isebenza ngokugxila kuphrotheni ethile ebizwa nge-PCSK9 esibindini sakho. Le phrotheni ngokuvamile ivimbela isibindi sakho ukuthi singasusi i-LDL cholesterol emsingeni wakho wegazi ngempumelelo.

Umuthi usebenzisa ubuchwepheshe be-RNA obuncane obuphazamisa ukuze "thulise" imfucuza eyenza iphrotheni ye-PCSK9. Lapho kuncane i-PCSK9 ezungezile, isibindi sakho singasusa i-cholesterol embi eningi egazini lakho, okufana nokususa amabhuleki kusistimu yakho yesibindi yokuhlanza i-cholesterol.

Le ndlela ithathwa njengeqine ngokulinganisela uma iqhathaniswa neminye imithi ye-cholesterol. Ngenkathi ama-statins eseyindlela yokuqala yokwelapha, i-inclisiran inganciphisa i-LDL cholesterol ngo-50% noma ngaphezulu uma ingezwa ekwelashweni okukhona.

Imiphumela ihlala izinyanga eziningana ngemuva komjovo ngamunye ngoba umuthi uqhubeka usebenza ezingeni lezakhi zofuzo. Yingakho udinga kuphela imijovo kabili ngonyaka esikhundleni sokuthatha amaphilisi nsuku zonke.

Kufanele Ngiyithathe Kanjani I-Inclisiran?

I-Inclisiran inikezwa njengomjovo ngaphansi kwesikhumba sakho nguchwepheshe wezempilo endaweni yezokwelapha. Ngeke uthathe lo muthi ekhaya noma ngomlomo.

Isheduli ejwayelekile iqala ngomjovo wakho wokuqala, olandelwa omunye umjovo emva kwezinyanga ezintathu, bese kuba njalo njalo ezinyangeni eziyisithupha ngemuva kwalokho. Udokotela wakho uzomaka lezi zinsuku ekhalendeni lakho ukuze ungaphuthelwa ama-aphoyintimenti.

Akudingeki ukuthi wenze lutho olukhethekile ngaphambi kokuqokwa kwakho komjovo. Ungadla ngokujwayelekile futhi uthathe eminye imithi yakho njengenjwayelo. Umjovo ngokwawo uthatha imizuzu embalwa nje futhi ufana nokuthola umgomo.

Ngemuva komjovo wakho, ungaqhubeka nemisebenzi ejwayelekile ngokushesha. Abanye abantu bazwa ubuhlungu obuncane endaweni yokujova, obufana nalobo ongase uzizwe ngemuva kwanoma yimuphi umjovo, kodwa lokhu kuvame ukunyamalala ngosuku olulodwa noma ezimbili.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Inclisiran?

I-Inclisiran ngokuvamile iyindlela yokwelapha yesikhathi eside yokulawula i-cholesterol ephezulu engapheli. Abantu abaningi baqhubeka nokuthola imijovo iminyaka eminingi, ngendlela efana nendlela abangase bathathe ngayo imithi ye-cholesterol yansuku zonke.

Udokotela wakho uzoqapha amazinga akho e-cholesterol kanye nempilo yakho yonke njalo ukuze anqume ukuthi i-inclisiran iyaqhubeka yini ukukulungela. Ngokuvamile bazohlola amazinga akho cishe ezinyangeni ezi-3-6 ngemuva kokuqala ukwelashwa bese kuthi ngezikhathi ezithile ngemuva kwalokho.

Isinqumo sokuqhubeka noma ukuyeka i-inclisiran sincike ekutheni isebenza kahle kangakanani, ukuthi ngabe uzwa imiphumela emibi, kanye nengozi yakho yonke yenhliziyo nemithambo yegazi. Abanye abantu bangase bagcine bedlulela kwezinye izindlela zokwelapha uma isimo sabo sishintsha.

Kubalulekile ukugcina imijovo yakho ehleliwe ngisho noma uzizwa kahle. I-cholesterol ephezulu ngokuvamile ayibangeli izimpawu, ngakho-ke ungase ungazizwa uhlukile ngisho noma imithi isebenza ukuvikela inhliziyo yakho nemithambo yegazi.

Yini Imiphumela Eceleni Ye-Inclisiran?

Abantu abaningi bayamela i-inclisiran kahle, kodwa njengayo yonke imithi, ingabangela imiphumela emibi. Izindaba ezinhle ukuthi imiphumela emibi engathí sina ayivamile.

Nansi imiphumela emibi evame kakhulu ongase uyithole:

• Ukuvuvukala endaweni yokujova, ukubomvu, noma ubuhlungu
• Ubuhlungu emalungeni noma imisipha
• Ukukhathala noma ukuzizwa ukhathele kunokujwayelekile
• I-Bronchitis noma izifo ezingenhla zokuphefumula
• Isiyezi noma ukuzizwa unovalo

Le miphumela emibi ivamise ukuba mncane futhi ithambekele ekuthuthukiseni ngokuhamba kwesikhathi njengoba umzimba wakho ujwayela imithi. Ukusabela endaweni yokujova kuvame ukuxazululwa ezinsukwini ezimbalwa.

Imiphumela emibi engavamile kodwa ebucayi ingabandakanya ukusabela okukhulu komzimba, nakuba lokhu kungavamile. Izimpawu zokusabela okukhulu komzimba zihlanganisa ubunzima bokuphefumula, ukuvuvukala ebusweni bakho noma emqaleni, noma ukuqubuka okusabalale.

Abanye abantu bakhathazeka ngezinkinga zesibindi, kodwa i-inclisiran ibonakala ithambile esibindini kunezinye izidakamizwa ze-cholesterol. Nokho, udokotela wakho uzolokhu eqapha ukusebenza kwesibindi sakho ngezivivinyo zegazi ngezikhathi ezithile.

Uma uhlangabezana nanoma yiziphi izimpawu ezingavamile ngemva komjovo wakho, unganqikazi ukuxhumana nomhlinzeki wakho wezempilo. Bangasiza ukuthola ukuthi lokho okuhlangenwe nakho kuhlobene yini nemithi nokuthi ungayiphatha kanjani.

Ubani Ongafanele Athathwe I-Inclisiran?

I-Inclisiran ayifanele wonke umuntu, futhi udokotela wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuyibhala. Umuthi awunconyelwe abantu abangaphansi kweminyaka engu-18 ubudala, njengoba ukuphepha kwawo nokusebenza kwawo kungakazinziswa ezinganeni.

Kufanele ugweme i-inclisiran uma uke waba nokusabela okukhulu komzimba kuyo noma kunoma yiziphi izithako zayo esikhathini esidlule. Udokotela wakho uzobuyekeza uhlu oluphelele lwezithako nawe uma wazi ukuthi unezifo ezithile.

Abesifazane abakhulelwe noma abancelisa ngamabele kufanele baxoxe ngezingozi nezinzuzo nodokotela wabo. Nakuba kukhona idatha elinganiselwe ekusetshenzisweni kwe-inclisiran ngesikhathi sokukhulelwa, ngokuvamile kunconywa ukuyigwema ngaphandle kokuthi izinzuzo zicace ngokusobala ngaphezu kwezingozi.

Abantu abanezimo ezithile zesibindi bangase badinge ukuqashwa okukhethekile noma bangase bangabi ngabantu abafaneleki kahle ku-inclisiran. Udokotela wakho uzohlola ukusebenza kwesibindi sakho ngaphambi kokuqala ukwelashwa futhi akuqaphele njalo.

Uma unomlando wokugula okukhulu kwezinso, udokotela wakho uzocabangela ngokucophelela ukuthi ngabe i-inclisiran ikufanele yini. Umuthi awukahlolisiswa kakhulu kubantu abanezinkinga ezinzima zezinso.

Amagama Omkhiqizo we-Inclisiran

I-Inclisiran ithengiswa ngaphansi kwegama lomkhiqizo elithi Leqvio e-United States nakwamanye amazwe amaningi. Leli yilona kuphela igama lomkhiqizo elitholakalayo njengamanje le-inclisiran.

I-Leqvio ikhiqizwa yi-Novartis futhi itholakala njengesirinji egcwaliswe ngaphambili yokujova. Umuthi uza ngomthamo ojwayelekile ongu-284 mg, okuyimali enikezwa ekujoveni ngakunye.

Ngokungafani neminye imithi enamagama amaningi omkhiqizo noma izinguqulo ezivamile, i-inclisiran isisha futhi ivikelwe ngamalungelo obunikazi. Lokhu kusho ukuthi i-Leqvio njengamanje iyona kuphela inguqulo etholakalayo.

Lapho ukhuluma ngalo muthi nodokotela wakho noma usokhemisi, ungalibiza ngokuthi i-inclisiran noma i-Leqvio. Bazokuqonda ukuthi ukhuluma ngomuthi ofanayo.

Ezinye izindlela ze-Inclisiran

Uma i-inclisiran ingakulungele, ziningi ezinye izinketho zokwehlisa i-cholesterol ezitholakalayo. Ama-statin ahlala engumuthi wokuqala futhi afaka imithi efana ne-atorvastatin, rosuvastatin, kanye ne-simvastatin.

Ezinye izithiyo ze-PCSK9 zifaka i-evolocumab (Repatha) kanye ne-alirocumab (Praluent). Lezi zisebenza ngendlela efanayo ne-inclisiran kodwa zinikezwa njengemijovo njalo emavikini amabili noma njalo ngenyanga, kunokuba kabili ngonyaka.

Kubantu abangakwazi ukubekezelela ama-statin, ezinye izindlela zifaka i-ezetimibe (Zetia), evimba ukumuncwa kwe-cholesterol emathunjini akho, kanye nama-bile acid sequestrants afana ne-cholestyramine.

Ezinye izindlela ezintsha zihlanganisa i-bempedoic acid (Nexletol), esebenza ngendlela ehlukile kunama-statins kodwa isanciphisa ukukhiqizwa kwe-cholesterol esibindini. Abanye abantu bakuthola kulula ukukubekezelela kunama-statins endabuko.

Udokotela wakho uzokusiza ukhethe inketho engcono kakhulu ngokusekelwe esimweni sakho esithile, okuhlanganisa amazinga akho e-cholesterol, ezinye izimo zempilo, nokuthi ukubekezelela kahle kangakanani imithi ehlukene.

Ingabe i-Inclisiran Ingcono Kune-Evolocumab?

Kokubili i-inclisiran ne-evolocumab (Repatha) yizithiyo ze-PCSK9 ezinciphisa ngempumelelo i-LDL cholesterol, kodwa zinezinzuzo ezihlukene ngokuya ngezintandokazi zakho nendlela yokuphila.

Inzuzo enkulu ye-inclisiran ukulula. Udinga kuphela imijovo kabili ngonyaka ngemuva kwesigaba sokuqala sokulayisha, uma kuqhathaniswa nemijovo ye-evolocumab yamasonto amabili noma yanyanga zonke. Lokhu kungaba lula kakhulu kubantu abangathandi imijovo ejwayelekile noma abanemisebenzi eminingi.

I-Evolocumab isitholakala isikhathi eside futhi inemininingwane eminingi yokuhlolwa komtholampilo, okuhlanganisa nezifundo ezikhombisa ukuthi inganciphisa ukuhlaselwa yinhliziyo nokushaywa unhlangothi. I-Inclisiran intsha, ngakho-ke ngenkathi inciphisa ngempumelelo i-cholesterol, sinemininingwane emincane yesikhathi eside ngemiphumela yenhliziyo nemithambo yegazi.

Zombili le mithi isebenza ngendlela efanayo ekwehliseni i-LDL cholesterol, ngokuvamile yehlisa amazinga ngo-50-60% uma ingezwa ekwelashweni kwe-statin. Ukukhetha phakathi kwazo kuvame ukwehla ezintandweni zemvamisa yomjovo nokuphendula komuntu ngamunye.

Izindleko nokukhokhelwa komshuwalense nakho kungathonya isinqumo. Udokotela wakho angakusiza ukuthi ulinganise lezi zici futhi unqume ukuthi iyiphi inketho enengqondo kakhulu esimweni sakho esithile.

Imibuzo Evame Ukubuzwa Mayelana ne-Inclisiran

Ingabe i-Inclisiran Iphephile Kubantu Abanesifo Sikashukela?

Yebo, i-inclisiran ibonakala iphephile kubantu abanesifo sikashukela futhi ingase ibe yinzuzo ngempela kulaba bantu. Abantu abanesifo sikashukela banengozi enkulu yesifo senhliziyo, okwenza ukuphathwa kwe-cholesterol okuphumelelayo kubaluleke kakhulu.

Umuthi awuthinti ngqo amazinga kashukela egazini, ngakho akufanele uphazamise ukuphathwa kwesifo sakho sikashukela. Kodwa-ke, udokotela wakho uzokuhlola ngokucophelela ngoba abantu abanesifo sikashukela bavame ukuthatha imithi eminingi.

Ezinye izifundo zikhomba ukuthi i-inclisiran ingase ibe nezinzuzo ezengeziwe ngaphandle kokwehlisa i-cholesterol ezingasiza ukuvikela ezinkingeni zesifo sikashukela, nakuba kudingeka ucwaningo olwengeziwe ukuqinisekisa le miphumela.

Kufanele ngenzeni uma ngiphuthelwa ngengozi umjovo wami we-Inclisiran?

Uma uphuthelwa umjovo wakho we-inclisiran ohleliwe, xhumana nehhovisi likadokotela wakho ngokushesha ngangokunokwenzeka ukuze uhlele kabusha. Imiphumela yomuthi iyancipha kancane kancane ngokuhamba kwesikhathi, ngakho ukubuyela esimisweni kubalulekile ekulawuleni i-cholesterol yakho.

Ungazami ukuthi "ulungise" umjovo ophuthelwe ngokuthola imithamo eyengeziwe. Udokotela wakho uzokusiza ukuthi unqume isikhathi esingcono somjovo wakho olandelayo ngokusekelwe ekutheni ugcine nini umuthi.

Uma uphuthelwe umjovo ngezinyanga eziningana, udokotela wakho angase ancome ukuhlola amazinga akho e-cholesterol ngaphambi kokukunika umthamo olandelayo. Lokhu kubasiza ukuthi baqonde ukuthi i-cholesterol yakho ishintshe kanjani futhi balungise uhlelo lwakho lokwelapha uma kudingeka.

Ngingayeka nini ukuthatha i-Inclisiran?

Isinqumo sokuyeka i-inclisiran kufanele senziwe ngaso sonke isikhathi ngokubonisana nodokotela wakho. Abantu abaningi abane-cholesterol ephezulu badinga ukwelashwa isikhathi eside, ngakho ukuyeka ngokuvamile akunconywa ngaphandle uma kunezizathu ezithile zezokwelapha.

Udokotela wakho angase acabange ukuyeka i-inclisiran uma uba nemiphumela emibi ebalulekile, uma imigomo yakho ye-cholesterol ishintsha ngenxa yokuthuthuka kwezinye izempilo, noma uma imithi emisha, efanelekayo itholakala.

Uma ucabanga ukuyeka ngoba uzizwa kahle, khumbula ukuthi i-cholesterol ephezulu ngokuvamile ayibangeli izimpawu. Umuthi usebenza ukuvimbela izinkinga zenhliziyo zesikhathi esizayo, hhayi ukwelapha izimpawu zamanje.

Ngingathatha i-Inclisiran neminye imithi yokwehlisa i-cholesterol?

Yebo, i-inclisiran ivame ukusetshenziswa kanye neminye imithi yokwehlisa i-cholesterol, ikakhulukazi ama-statins. Eqinisweni, ngokuvamile ingezwa ekwelashweni kwe-cholesterol okukhona kunokuthi ithathelwe indawo ngokuphelele.

Inhlanganisela ye-inclisiran nama-statins ingasebenza kahle kakhulu, ngokuvamile ifinyelela ekunciphiseni i-cholesterol okungekho emithi engakwazi ukuyenza yodwa. Le ndlela ilusizo ikakhulukazi kubantu abane-cholesterol ephezulu kakhulu noma labo abasengozini enkulu yesifo senhliziyo.

Udokotela wakho uzoqondisa ngokucophelela yonke imithi yakho ukuze aqinisekise ukuthi isebenza kahle ndawonye futhi ayibangeli ukuxhumana okuyingozi. Hlala wazisa bonke abahlinzeki bakho bezempilo ngayo yonke imithi oyithathayo, okuhlanganisa i-inclisiran.

Isebenza ngokushesha kangakanani i-Inclisiran?

I-Inclisiran iqala ukusebenza ezinsukwini ngemva komjovo wakho, kodwa uzozibona imiphumela ephezulu yokwehlisa i-cholesterol ngemva kwezinyanga ezi-3. Yingakho udokotela wakho ehlela umjovo wakho wesibili ezinyangeni ezintathu ngemva kowokuqala.

Udokotela wakho ngokuvamile uzohlola amazinga akho e-cholesterol cishe ezinyangeni ezi-3-6 ngemva kokuqala ukwelashwa ukuze abone ukuthi imithi isebenza kahle kangakanani. Abantu abaningi babona ukuthuthuka okukhulu ezinombolweni zabo ze-cholesterol kulokhu kuhlolwa kokuqala.

Imiphumela yemithi yakha ngokuhamba kwesikhathi, ngakho ungase ubone imiphumela engcono ngisho nangemva kwemijovo eminingana. Lokhu kujwayelekile futhi kulindelekile ngemithi ye-inclisiran.