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

I-Ocrelizumab iyimithi kadokotela esiza ukunciphisa i-multiple sclerosis (MS) ngokugxila kumaseli athile omzimba. Inikezwa ngomjovo we-IV ehhovisi likadokotela wakho noma esikhungweni sokufaka imithi, ngokuvamile njalo ezinyangeni eziyisithu kanyemba ngemva kwemithamo yakho yokuqala.

Le mithi imelela intuthuko enkulu ekwelashweni kwe-MS, inikeza ithemba kubantu abanezinhlobo zombili ezibuyayo nezithuthukayo zalesi sifo. Ukuqonda ukuthi isebenza kanjani nokuthi yini ongayilindela kungakusiza uzizwe uqiniseka kakhulu ngohambo lwakho lokwelashwa.

Yini i-Ocrelizumab?

I-Ocrelizumab iyisidakamizwa esikhethekile esiqondisa amaseli e-B emzimbeni wakho. Lawa maseli e-B adlala indima ebalulekile enqubweni ye-autoimmune elimaza imicu yezinzwa ku-multiple sclerosis.

Cabanga ngayo njengemithi enembile kakhulu esebenza njengemishini eqondisiwe, ifuna futhi ibopheke kumaprotheni athile abizwa ngokuthi i-CD20 kumaseli e-B. Uma isinamathele, isiza ukunciphisa inani lala maseli angabangela ukuvuvukala ohlelweni lwakho lwezinzwa.

Le mithi ingeyodwa ebizwa ngokuthi ama-therapies aguqula izifo (ama-DMTs), okusho ukuthi ayelaphi nje izimpawu kuphela kodwa empeleni asebenza ukunciphisa ukuqhubeka kwe-MS ngokwayo. Lokhu kuyenza ihluke kakhulu emithini esiza kuphela ngezimpawu ezithile njengama-muscle spasms noma ukukhathala.

Isetshenziselwani i-Ocrelizumab?

I-Ocrelizumab ivunywe yi-FDA ukwelapha izinhlobo ezimbili eziyinhloko ze-multiple sclerosis. Yimithi yokuqala neyodwa kuphela evunyelwe i-primary progressive MS, okuyenza ibaluleke kakhulu kubantu abanalesi sifo.

Ezinhlotsheni ze-MS ezibuyayo, lokhu kuhlanganisa i-relapsing-remitting MS kanye ne-active secondary progressive MS. Lezi yizinhlobo lapho abantu behlangabezana khona nokuhlaselwa okucacile noma ukuphindeka okulandelwa izikhathi zokululama noma ukuzinza.

Udktela wakho angase ancome i-ocrelizumab uma ungazange uphendule kahle kwezinye izindlela zokwelapha i-MS, noma uma une-primary progressive MS lapho ezinye izinketho zilinganiselwe. Kwesinye isikhathi futhi kukhethwa njengendlela yokwelapha yokuqala kubantu abane-relapsing MS esebenza kakhulu.

Isebenza Kanjani I-Ocrelizumab?

I-Ocrelizumab isebenza ngokunciphisa amaseli e-B, okuyizicubu zomzimba ezifaka isandla enkingeni yokuvuvukala ku-MS. Lokhu kuthathwa njengendlela eqinile ngokulinganisela yokwelapha i-MS, eqine kakhulu kunezinye izidakamizwa eziphuzwayo kodwa ingabanzi kangako kunezinye izindlela zokwelapha ngokufaka imithi emithanjeni.

Umuthi ubopha amaprotheni e-CD20 ngaphezulu kwamaseli e-B, uwamaka ukuze abhujiswe amasosha akho omzimba. Le nqubo inciphisa kakhulu inani lamaseli e-B azungeza emzimbeni wakho izinyanga eziningana.

Okuthuthukisa le ndlela ukuthi isebenza kahle ukuthi iqondise amaseli athile omzimba abambe iqhaza elikhulu ekuqhubekeleni phambili kwe-MS ngenkathi ishiya ezinye izingxenye zomzimba wakho zivikelekile. Ukuncipha kwamaseli e-B kuvame ukuhlala izinyanga eziningana, yingakho umuthi unikezwa njalo ezinyangeni eziyisithupha.

Ngemuva kwamasonto ambalwa okwelashwa, uzoba namaseli e-B ambalwa kakhulu ohlelweni lwakho. Ngokuhamba kwesikhathi, lawa maseli abuya kancane kancane, kodwa imiphumela yomuthi ekunciphiseni ukuqhubeka kwe-MS ingaqhubeka ngisho nalapho izinombolo zamaseli e-B zibuyela esimweni esijwayelekile.

Kufanele Ngiyithathe Kanjani I-Ocrelizumab?

I-Ocrelizumab inikezwa kuphela ngokufakwa ngomthambo esikhungweni sezokwelapha, hhayi ekhaya. Umthamo wakho wokuqala uvame ukuhlukaniswa ube izifakelo ezimbili ezinikezwa ngemva kwamasonto amabili, ngasinye isifakelo sithatha cishe amahora angu-2.5 kuya kwangu-3.5.

Ngaphambi kokufakwa ngakunye, uzothola imithi yangaphambi kokwelashwa ukusiza ekuvikeleni ukusabela kokufakwa. Lokhu kuvame ukuhlanganisa i-antihistamine efana ne-diphenhydramine, i-corticosteroid efana ne-methylprednisolone, futhi ngezinye izikhathi i-acetaminophen. Le mithi isiza umzimba wakho ukuthi ukwazi ukubekezelela ukufakwa kangcono.

Akudingeki ukuthi uthathe i-ocrelizumab nokudla ngoba inikezwa ngqo emgudwini wakho wegazi. Kodwa-ke, ukudla ukudla okulula ngaphambi kokuqokwa kwakho kokufakwa kungakusiza ukuthi uzizwe ukhululekile ngesikhathi senqubo ende.

Ngesikhathi sokufakwa, abasebenzi bezokwelapha bazokuqapha eduze nganoma yiziphi izindlela zokuphendula. Umuthi unikezwa kancane ekuqaleni, bese izinga lingakhuphuka uma ulithola kahle. Abantu abaningi bangakwazi ukufunda, basebenzise ifoni yabo, noma balale ngesikhathi sokufakwa.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Ocrelizumab?

I-Ocrelizumab ngokuvamile iyindlela yokwelapha yesikhathi eside ozoqhubeka nayo uma nje isiza i-MS yakho futhi uyithola kahle. Abantu abaningi bahlala kulo muthi iminyaka eminingi, ngokuqapha njalo ukuze baqinisekise ukuthi ihlala iphephile futhi isebenza kahle.

Udokotela wakho uzohlola impendulo yakho ekwelashweni njalo ezinyangeni eziyisithu, ngokuvamile ngesikhathi sokufakwa kwakho okulandelayo. Bazobheka izinto ezinjengokuphindeka okusha, izinguquko ze-MRI, ukuqhubeka kokukhubazeka, nanoma yimaphi imiphumela emibi oyitholayo.

Abanye abantu bangase badinge ukuyeka i-ocrelizumab uma bethola izifo ezinzima, imithombo ethile yomdlavuza, noma izindlela zokuphendula ezinkulu zokufakwa. Udokotela wakho uzoxoxa nawe ngalezi zingozi futhi aqaphe noma yiziphi izimpawu zokuthi umuthi kufanele uyekwe.

Isinqumo sokuqhubeka noma ukuyeka i-ocrelizumab kufanele senziwe ngaso sonke isikhathi kanye nochwepheshe wakho we-MS, ulinganisa izinzuzo ozitholayo ngokumelene nanoma yiziphi izingozi noma imiphumela emibi oyitholayo.

Yiziphi Imiphumela Emibi Ye-Ocrelizumab?

Njengayo yonke imithi, i-ocrelizumab ingabangela imiphumela emibi, nakuba abantu abaningi beyithola kahle. Imiphumela emibi evame kakhulu ihlobene nenqubo yokufakwa kanye nokwanda kokuthambekela ezifweni.

Nawa imiphumela emibi ebikwa kaningi ongase uyithole:

• Ukusabela kokufakwa kwemithambo njengobubomvu besikhumba, ukuluma, noma umkhuhlane olula ngesikhathi noma ngemuva nje kokwelashwa
• Izifo ezingaphezulu zokuphefumula ezifana nomkhuhlane noma izifo ze-sinus
• Izifo zesikhumba noma ukuqubuka kwe-herpes yomlomo
• Ukukhathala okungase kuqhubeke izinsuku ezimbalwa ngemuva kokufakwa
• Ikhanda noma izinhlungu zomzimba ezilula
• Isicanucanu noma ukuphazamiseka kokugaya ukudla

Le miphumela evamile emibi ngokuvamile iyalawuleka futhi ivame ukuthuthuka njengoba umzimba wakho ujwayela imithi.

Imiphumela emibi engathi sína kodwa engavamile idinga ukunakekelwa kwezokwelapha ngokushesha futhi ihlanganisa:

• Ukusabela okukhulu kokufakwa ngobunzima bokuphefumula, ukuvuvukala okukhulu, noma izinhlungu esifubeni
• Izimpawu zezifo ezingathi sína njengomkhuhlane oqhubekayo, ukukhathala okukhulu, noma izimpawu ezingavamile
• I-Progressive multifocal leukoencephalopathy (PML), isifo esingavamile sobuchopho
• Ukuvuselelwa kwe-Hepatitis B kubantu abake bahlangabezana nayo
• Izinhlobo ezithile zomdlavuza, ikakhulukazi umdlavuza wamabele

Ithimba lakho lezempilo lizokuqapha ngokucophelela ukuze lithole lezi zinkinga ezingavamile kodwa ezingathi sína ngokusebenzisa ukuhlolwa kwegazi okujwayelekile nokuhlolwa.

Ubani Ongafanele Athathwe I-Ocrelizumab?

I-Ocrelizumab ayifanele wonke umuntu one-MS. Udokotela wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha ukuze anqume ukuthi lo muthi uphephile yini kuwe.

Akufanele uthathe i-ocrelizumab uma unokutheleleka okusebenzayo kwe-hepatitis B, njengoba imithi ingabangela ukuthi leli gciwane libe semsebenzini oyingozi futhi. Uzodinga ukuhlolwa kwegazi ukuze uhlole i-hepatitis B ngaphambi kokuqala ukwelashwa.

Abantu abanezifo ezingathi sína eziqhubekayo kufanele balinde kuze kube yilapho lezi zifo ziphathwe ngokugcwele ngaphambi kokuqala i-ocrelizumab. Lokhu kuhlanganisa izifo zamagciwane, amagciwane, noma ezingavela emfungweni ezingase zibe zimbi uma amasosha akho omzimba ecindezelwe.

Uma uke waba nokusabela okukhulu komzimba ku-ocrelizumab noma imithi efanayo esikhathini esidlule, lokhu kwelashwa akukhuthazwa. Udokotela wakho uzochaza ezinye izindlela ezingase ziphephe kuwe.

Abesifazane abakhulelwe akufanele bathole i-ocrelizumab, njengoba ingalimaza ingane esakhula. Uma uhlela ukukhulelwa, xoxa ngalokhu nodokotela wakho kusenesikhathi, njengoba umuthi ungase uthinte amasosha akho omzimba izinyanga ngemuva komthamo wakho wokugcina.

Amagama Omkhiqizo we-Ocrelizumab

I-Ocrelizumab ithengiswa ngaphansi kwegama lomkhiqizo elithi Ocrevus e-United States nakwamanye amazwe amaningi. Leli yilo kuphela igama lomkhiqizo elitholakalayo njengamanje, njengoba kungekho okwamanje izinhlobo ezivamile zalo muthi.

I-Ocrevus ikhiqizwa yi-Genentech e-US kanye ne-Roche kwamanye amazwe. Zombili lezi zinkampani ziyingxenye yeqembu elifanayo lemithi, ngakho-ke umuthi uyafana ngempela kungakhathaliseki ukuthi ukhiqizwa kuphi.

Lapho nixoxa ngokwelashwa kwakho nabahlinzeki bezempilo noma izinkampani zomshuwalense, ningase nizwe womabili la magama esetshenziswa ngokushintshana. Ochwepheshe bezokwelapha abathile bakhetha ukusebenzisa igama elivamile (ocrelizumab) kanti abanye basebenzisa igama lomkhiqizo (Ocrevus).

Ezinye Izindlela Zokwelapha ze-Ocrelizumab

Eminye imithi eminingi ingelapha i-MS, nakuba ukukhetha okungcono kuncike ohlotsheni lwakho oluthile lwe-MS kanye nezimo zomuntu ngamunye. Udokotela wakho uzokusiza ukuthi uhlole izinzuzo nobubi benketho ngayinye.

Nge-relapsing MS, ezinye izindlela zokwelapha zihlanganisa imithi yomlomo efana ne-fingolimod (Gilenya), i-dimethyl fumarate (Tecfidera), noma i-teriflunomide (Aubagio). Lokhu kuvame ukuba lula ukukuthatha kodwa kungase kungasebenzi kahle ezifweni ezisebenzayo kakhulu.

Ezinye izindlela zokwelapha zokufaka ngomjovo zihlanganisa i-natalizumab (Tysabri) kanye ne-alemtuzumab (Lemtrada), zombili ezisebenza ngendlela ehlukile kune-ocrelizumab. I-Natalizumab inikezwa njalo ngenyanga, kuyilapho i-alemtuzumab ihilela izifundo ezimbili zokwelashwa ngonyaka ngamunye.

Nge-MS eqhubekayo eyinhloko, i-ocrelizumab njengamanje iyona kuphela ukwelashwa okuvunyelwe yi-FDA, okuyenza ibe yizinga legolide lolu hlobo lwesifo. Kodwa-ke, odokotela abathile bangase bacabange ukusebenzisa eminye imithi ngaphandle kwemvume ezimweni ezithile.

Ingabe i-Ocrelizumab Ingcono Kune-Rituximab?

I-Ocrelizumab ne-rituximab ziyimithi efana ehloselwe amaseli e-B, kodwa i-ocrelizumab yenzelwe ngqo futhi yavunywa ukwelapha i-MS. I-Rituximab isetshenziswa ikakhulukazi emithini ethile yomdlavuza nezifo ze-autoimmune, nakuba abanye odokotela bayisebenzisile ngaphandle kwemvume ye-MS.

I-Ocrelizumab ithathwa njengeyinhle kune-rituximab, enezinguquko eziyenza iphephe futhi isebenze kahle nge-MS. Yenzelwe ukuthi ingabi ne-immunogenic encane, okusho ukuthi umzimba wakho mancane amathuba okuthi uzokwakha ama-antibody ayiphikisayo.

Idatha yezivivinyo zomtholampilo ye-ocrelizumab ku-MS ibanzi kakhulu kune-rituximab, inikeza odokotela ulwazi olungcono mayelana nokusebenza kwayo kanye nephrofayili yokuphepha. Lokhu kwenza i-ocrelizumab ibe yindlela ekhethwayo yezazi eziningi ze-MS.

Kodwa-ke, i-rituximab ingase isetshenziswe ngezinye izikhathi uma i-ocrelizumab ingatholakali noma ingahlanganiswa ngumshuwalense, njengoba le mithi emibili isebenza ngezindlela ezifanayo kakhulu. Udokotela wakho angakusiza ukuthi uqonde ukuthi iyiphi inketho engase ibe ngcono esimweni sakho esithile.

Imibuzo Evame Ukubuzwa Nge-Ocrelizumab

Ingabe i-Ocrelizumab Iphephile Kubantu Abanezifo Zenhliziyo?

I-Ocrelizumab ngokuvamile ingasetshenziswa ngokuphepha kubantu abanezifo zenhliziyo, kodwa udokotela wakho wenhliziyo kanye nodokotela wezinzwa kuzodingeka bahlele ukunakekelwa kwakho. Okukhathaza kakhulu ukuthi ukusabela kokufakwa kungase kuqhubekisele inhliziyo yakho.

Ngaphambi kokuqala ukwelashwa, udokotela wakho uzohlola isimo senhliziyo yakho futhi angase ancome ukuqapha okwengeziwe ngesikhathi sokufakwa. Abanye abantu abanezinkinga ezinkulu zenhliziyo bangase badinge ukuthi ukufakwa kwabo kunikezwe kancane noma endaweni yasesibhedlela kunendawo yokufakwa kwabantu abangaphandle.

Kumele Ngenzeni Uma Ngiphuthelwe Umthamo We-Ocrelizumab Ngengozi?

Xhumana nehhovisi likadokotela wakho ngokushesha nje lapho uqaphela ukuthi uphuthelwe ukuqokwa kwakho kokufakwa komuthi okuhleliwe. Bazokusiza ukuthi uhlele kabusha ngokushesha ngangokunokwenzeka, okungcono phakathi kwamasonto ambalwa edethi yakho ephuthelwe.

Ukuphuthelwa imithamo kunganciphisa ukusebenza kahle komuthi futhi kungavumela umsebenzi we-MS ukuthi ubuye. Kodwa-ke, ungesabi uma uphuthelwa ukuqokwa ngenxa yokugula noma ezinye izimo. Ithimba lakho lezokwelapha lizosebenza nawe ukuze ubuyele emgwaqeni ngokuphepha.

Kumele Ngenzeni Uma Nginokuphendula Okukhulu Ngesikhathi Sokufakwa Komuthi?

Tshela umhlengikazi wakho wokufakwa komuthi ngokushesha uma uhlangabezana nanoma yiziphi izimpawu ezikhathazayo ngesikhathi sokwelashwa. Izimpawu ezivamile zokuphendula kokufakwa komuthi zihlanganisa ukubomvu kwesikhumba, ukuluma, ubunzima bokuphefumula, ukuqina kwesifuba, noma ukuzizwa udidekile.

Abasebenzi bezokwelapha baqeqeshwe ukubhekana nalezi zimo futhi cishe bazonciphisa noma bayeke ukufakwa komuthi, bakunikeze imithi eyengeziwe, futhi bakuqaphe eduze. Iningi lezimphendulo zokufakwa komuthi liyaphathwa futhi alikuvimbeli ekuqedeni ukwelashwa, nakuba kungase kuthathe isikhathi eside.

Ngingayeka Nini Ukuthatha I-Ocrelizumab?

Isinqumo sokuyeka i-ocrelizumab kufanele senziwe ngaso sonke isikhathi nochwepheshe wakho we-MS, hhayi wedwa. Akukho mkhawulo wesikhathi obekiwe wokwelashwa, njengoba abantu abaningi bazuza ekuhlaliseni emuthini isikhathi eside.

Udokotela wakho angase ancome ukuyeka uma uthola imiphumela emibi engathi sína, uma i-MS yakho ingasebenzi isikhathi eside, noma uma udinga ukuqala umndeni. Bazokusiza ukuthi ulinganise izingozi nezinzuzo zokuqhubeka nokumisa ukwelashwa.

Ngingakwazi Yini Ukuthola Imigomo Ngenkathi Ngithatha I-Ocrelizumab?

Ungathola imigomo eminingi ngenkathi use-ocrelizumab, kodwa ingase ingasebenzi kahle ngoba amasosha akho omzimba acindezelwe. Udokotela wakho uzoncoma ukuqeda noma yimiphi imigomo edingekayo ngaphambi kokuqala ukwelashwa uma kungenzeka.

Imigomo ephilayo kufanele igwenywe ngenkathi uthatha i-ocrelizumab, njengoba ingase ibangele izifo. Lokhu kufaka phakathi imigomo efana nomgomo womkhuhlane ophilayo, i-MMR, kanye nomgomo we-varicella (izinkukhu). Kodwa-ke, imigomo engasebenzi njengomgomo ovamile womkhuhlane ngokuvamile iphephile futhi iyatuswa.