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

I-Ravulizumab iyimithi enamandla kadokotela esiza ukwelapha izifo ezingavamile zegazi ngokuvimbela amasosha akho omzimba ekuhlaseleni amaseli abomvu egazi anempilo. Le mithi ekhethekile isebenza ngokuvimba ingxenye ethile yamasosha akho omzimba ebizwa ngokuthi uhlelo lokwengeza, olungase ngezinye izikhathi lungene ekusebenzeni ngokweqile futhi lubange izinkinga ezinkulu zempilo.

Uma udokotela wakho ekhulume nge-ravulizumab njengenketho yokwelapha, cishe ubhekene nesimo esiyinkimbinkimbi esidinga ukuphathwa ngokucophelela. Le mithi imelela intuthuko enkulu ekwelapheni izifo ezingavamile ezithile, inikeza ithemba kanye nekhwalithi yempilo ethuthukisiwe kubantu ababenokukhetha okulinganiselwe ngaphambili.

Yini i-Ravulizumab?

I-Ravulizumab wuhlobo lomuthi obizwa ngokuthi i-monoclonal antibody eqondise futhi ivimbele iphrotheni emasosheni akho omzimba ebizwa ngokuthi i-C5. Cabanga ngayo njengomqaphi oqeqeshwe kakhulu ovimbela umuntu oyedwa okhathazayo ohlelweni lokuzivikela lomzimba wakho ukuthi angabangeli umonakalo.

Le mithi ingeyeqembu lezidakamizwa ezibizwa ngokuthi ama-complement inhibitors. Uhlelo lokwengeza ngokuvamile luyasiza ekulweni nezifo, kodwa ezifweni ezingavamile ezithile, luba ngaphezu kokusebenza futhi luqala ukuhlasela amaseli akho anempilo. I-Ravulizumab ingena ukuze ithulise le mpendulo engaphezu kokusebenza.

Uzothola i-ravulizumab kuphela ngokufakwa kwe-IV esibhedlela noma emtholampilo okhethekile. Ayitholakali njengepilisi noma umjovo ongawuthatha ekhaya. Umuthi uza njengoketshezi olucacile, olungenambala oluzolungiswa ngokucophelela futhi lunikezwe ochwepheshe bezempilo.

Isetshenziselwani i-Ravulizumab?

I-Ravulizumab iphatha izifo ezimbili eziyinhloko ezingavamile zegazi lapho amasosha akho omzimba ebulala ngamaphutha amaseli abomvu egazi anempilo. Lezi zimo zingasongela impilo ngaphandle kokwelashwa okufanele, kodwa i-ravulizumab ingasiza ukuzilawula ngempumelelo.

Isimo sokuqala esisiphatha yisifo i-paroxysmal nocturnal hemoglobinuria, esivame ukubizwa nge-PNH. Ku-PNH, amaseli akho abomvu egazi awanayo ingubo evikelayo, okwenza abe sengozini yokubulawa yisistimu yakho yokuzivikela emzimbeni. Lokhu kuholela ku-anemia enkulu, ukukhathala, kanye namahlule egazi angaba yingozi.

I-Ravulizumab iphatha futhi i-atypical hemolytic uremic syndrome, eyaziwa nge-aHUS. Lesi simo senza ukuthi amasosha akho omzimba ahlasela hhayi nje amaseli abomvu egazi, kodwa futhi alimaze izinso zakho nezinye izitho. Ngaphandle kokwelashwa, i-aHUS ingaholela ekwehlulekeni kwezinso nezinye izinkinga ezinzima.

Zombili lezi zimo zithathwa njengezifo ezingavamile, ezithinta inani elincane kuphela labantu emhlabeni jikelele. Kodwa-ke, kulabo abanazo, i-ravulizumab ingashintsha impilo ngempela, ivame ukumisa ukuqhubeka kwesifo futhi ivumele abantu ukuthi babuyele emisebenzini ejwayelekile.

Isebenza Kanjani I-Ravulizumab?

I-Ravulizumab isebenza ngokuvimba iphrotheni ethile ebizwa nge-C5 kusistimu yakho yokugcwalisa. Lapho i-C5 isiqalisiwe, iqala uchungechunge lwezenzakalo olugcina lubulala amaseli abomvu egazi anempilo futhi lonakalisa imithambo yegazi.

Ngokubopha ngokuqinile ku-C5, i-ravulizumab ivimbela le nqubo yokucekela phansi ukuthi ingaqali. Kufana nokufaka ilokhi emnyango oholela ekubhujisweni kwamaselula. Lokhu kuvumela amaseli akho abomvu egazi ukuthi asinde isikhathi eside futhi asebenze kahle.

Lo muthi uthathwa njengonamandla kakhulu futhi usebenza kahle ekusetshenzisweni kwawo okuhlosiwe. Izifundo zomtholampilo zikhombisa ukuthi inganciphisa ngokushesha ukuhlakazeka kwamaseli abomvu egazi kubantu abaningi abane-PNH noma i-aHUS. Imiphumela ivamise ukuqala phakathi nezinsuku kuya emavikini ngemuva kokuqala ukwelashwa.

Ngokungafani neminye imithi esebenza emzimbeni wakho wonke, i-ravulizumab inendlela eqondiswe kakhulu. Ithinta kuphela ingxenye ethile yesistimu yakho yokuzivikela emzimbeni ebangela izinkinga, ishiya ezinye izivikelo zakho zomzimba zizimele ukulwa nezifo.

Kufanele Ngiyithathe Kanjani I-Ravulizumab?

Uzothola i-ravulizumab njenge-infusion ye-intravenous, okusho ukuthi iya ngqo egazini lakho ngentambo engalweni yakho. Lonke le nqubo yenzeka esibhedlela noma emtholampilo okhethekile lapho ochwepheshe bezempilo bengakugada ngokusondele.

I-infusion ngokwayo ngokuvamile ithatha cishe amahora angu-1 kuya kwangu-3, kuye ngomthamo wakho othile nokuthi uyawuthwala kahle kangakanani. Uzohlala kahle ngalesi sikhathi, futhi abantu abaningi bafunda, basebenzisa amafoni abo, noma baphumule ngesikhathi sokwelashwa.

Ngaphambi kwe-infusion ngayinye, ithimba lakho lezempilo lizohlola izimpawu zakho ezibalulekile futhi libuze nganoma yiziphi izimpawu obhekane nazo. Bazophinda baqinisekise ukuthi usesikhathini sokugonywa okuthile, ikakhulukazi lezo ezivikela ezinzwaneni zamagciwane.

Akudingeki ukuthi ugweme ukudla noma ukuphuza ngaphambi kwe-infusion yakho, futhi akukho mingcele ekhethekile yokudla. Kodwa-ke, kungumqondo omuhle ukudla ukudla okulula ngaphambi kwesikhathi futhi ulethe ukudla okulula namanzi ukuze uhlale ukhululekile ngesikhathi sokufakwa isikhathi eside.

Ithimba lakho lezokwelapha lizokunikeza imiyalelo ethile mayelana nokuthi yini ongayilindela nokuthi uzilungiselele kanjani ukuqokwa ngakunye. Bazophinda bakunikeze ulwazi mayelana nezimpawu zokuxwayisa okufanele uzibheke phakathi kokwelashwa.

Kufanele Ngithathe Isikhathi Esingakanani I-Ravulizumab?

Abantu abaningi abane-PNH noma i-aHUS badinga ukuqhubeka nokwelashwa nge-ravulizumab unomphela ukuze balawule isimo sabo. Lezi yizimo ezingapheli ezidinga ukuphathwa okuqhubekayo, njengokuthi isifo sikashukela noma umfutho wegazi ophezulu.

Uhlelo lwakho lokwelashwa ngokuvamile luzoqala ngama-infusion avamile ezinyangeni ezimbalwa zokuqala, bese lusabalala njalo ngamaviki angu-8 uma isimo sakho sizinzile. Lolu hlelo lokulondoloza lusiza ukugcina amazinga aqhubekayo emithi ohlelweni lwakho.

Abanye abantu bangase bakwazi ukuhlukanisa ukwelashwa kwabo uma beqhubeka kahle, kanti abanye bangase badinge imithamo evame kakhulu. Udokotela wakho uzoqapha umsebenzi wegazi lakho nezimpawu ukuze anqume uhlelo olungcono kakhulu kuwe.

Isinqumo sokuyeka noma ukushintsha ukwelashwa kwakho kufanele senziwe ngaso sonke isikhathi neqembu lakho lezempilo. Ukuyeka i-ravulizumab kungazelelwe kungabangela ukuthi isimo sakho esingaphansi sibuyele ngokushesha, okungenzeka kuholele ezinkingeni ezinzima.

Ukuqokwa okuvamile kokuqapha phakathi kokufakwa kusiza ukuqinisekisa ukuthi umuthi uyaqhubeka usebenza ngempumelelo futhi kuvumela udokotela wakho ukuthi abambe noma yiziphi izinguquko esimweni sakho ekuqaleni.

Yiziphi Imiphumela Eceleni Ye-Ravulizumab?

Njengayo yonke imithi enamandla, i-ravulizumab ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle uma umzimba wabo usujwayele ukwelashwa. Imiphumela emibi evame kakhulu ngokuvamile ithambile futhi iyaphathwa.

Nansi imiphumela emibi ongase uyithole, ukhumbula ukuthi wonke umuntu usabela ngendlela ehlukile emithini:

• Ikhanda, elivame ukuthuthuka ngokuhamba kwesikhathi kanye nezidambisi zokucasuka
• Ukukhathala noma ukukhathala, ikakhulukazi ngemva kokufakwa okumbalwa kokuqala
• Isicanucanu noma isisu esincane
• Isiyezi noma ukukhanya ekhanda
• Ubuhlungu emhlane noma ubuhlungu bemisipha
• Ukhwehlela noma izimpawu ezinjengomkhuhlane

Le miphumela emibi evamile ivame ukungabonakali njengoba umzimba wakho ujwayela umuthi. Abantu abaningi bathola ukuthi ukuhlala unamanzi kahle nokuthola ukuphumula okwanele kusiza ukunciphisa le miphumela.

Kukhona neminye imiphumela emibi engathi sína edinga ukunakekelwa kwezempilo ngokushesha, nakuba ingavamile. Okubaluleke kakhulu okufanele ukwazi ngakho ukwanda kwengozi yokutheleleka okungathi sína, ikakhulukazi emabhaktheriya ngokuvamile angabangeli izinkinga kubantu abanempilo.

Izimpawu zokutheleleka okukhulu okudinga ukunakekelwa kwezempilo ngokushesha zihlanganisa umkhuhlane, amaqhwa, ikhanda elibuhlungu kakhulu, ukuqina kwentamo, ukudideka, noma ukuqubuka okungashintshi umbala uma kucindezelwe. Lezi zimpawu zingase zibonise ukutheleleka okusongela impilo okudinga ukwelashwa okuphuthumayo.

Abanye abantu bangase babe nokusabela komzimba ngesikhathi noma ngemva nje kokufakwa. Ithimba lakho lezempilo liqaphela izimpawu ezinjengobunzima bokuphefumula, ukuvuvukala kobuso noma umphimbo, ukulunywa okukhulu, noma ukuqubuka okusabalale. Yingakho uzoqashwa eduze ngesikhathi sokwelashwa ngakunye.

Imiphumela emibi engavamile kodwa engathi sína ingahlanganisa izinkinga zesibindi, okuzoqashwa udokotela wakho ngokuhlolwa kwegazi okuvamile. Izimpawu ezinjengokuphuzi kwesikhumba noma amehlo, umchamo omnyama, noma ubuhlungu obukhulu besisu kufanele kubikwe ngokushesha.

Ubani Ongafanele Athole I-Ravulizumab?

I-Ravulizumab ayiphephile kuwo wonke umuntu, futhi udokotela wakho uzohlola ngokucophelela ukuthi ilungele yini. Okubaluleke kakhulu ukuthi ngabe unokutheleleka okusebenzayo, ikakhulukazi izifo zamagciwane.

Abantu abanezifo ezingalawuleki akufanele bathole i-ravulizumab ngoba umuthi ungenza kube nzima ukuthi umzimba wakho ulwe namagciwane. Udokotela wakho uzokwelapha noma yiziphi izifo ezisebenzayo ngaphambi kokuqala lo muthi.

Uma uke waba nokusabela komzimba okukhulu ku-ravulizumab noma kunoma iyiphi yezingxenye zayo esikhathini esidlule, akufanele uphinde uyithole. Ithimba lakho lezempilo lizobuyekeza umlando wakho wokungezwani komzimba ngokucophelela ngaphambi kokwelashwa kwakho kokuqala.

Abesifazane abakhulelwe badinga ukucatshangelwa okukhethekile, njengoba kungekho lwazi olwanele mayelana nokuthi i-ravulizumab ithinta kanjani izingane ezisakhula. Uma ukhulelwe noma uhlela ukukhulelwa, xoxa ngezingozi nezinzuzo ngokucophelela nodokotela wakho.

Abantu abanezinhlobo ezithile zomdlavuza noma ezinye izimo eziphazamisa kakhulu amasosha omzimba kungenzeka bangabi ngabazali abahle be-ravulizumab. Udokotela wakho uzohlola isimo sakho sempilo esiphelele ngaphambi kokuncoma ukwelashwa.

Uma uthatha eminye imithi ecindezela amasosha akho omzimba, udokotela wakho uzodinga ukulinganisela ngokucophelela izinzuzo nezingozi zokwengeza i-ravulizumab ohlelweni lwakho lokwelapha.

Igama Lomkhiqizo le-Ravulizumab

I-Ravulizumab ithengiswa ngaphansi kwegama lomkhiqizo elithi Ultomiris emazweni amaningi, okuhlanganisa ne-United States. Leli yigama ozolibona emalebuli emithi yakho nasemapepheni omshwalense.

Igama eliphelele elivamile lithi ravulizumab-cwvz, lapho ingxenye ethi "cwvz" iyisijobelelo esisiza ukuyihlukanisa neminye imithi efanayo. Kodwa-ke, ochwepheshe bezempilo abaningi neziguli bamane babhekisele kuyo njenge-ravulizumab noma i-Ultomiris.

I-Ultomiris yenziwa yi-Alexion Pharmaceuticals, inkampani egxile ekwelapheni izifo ezingavamile. Umuthi uyatholakala emazweni amaningi athuthukile, nakuba ukutholakala kungahluka kuye ngendawo yakho kanye nohlelo lwezempilo.

Ezinye Izindlela Zokwelapha nge-Ravulizumab

Enye indlela yokwelapha nge-ravulizumab yi-inhibitor eyinhloko yokugcwalisa ebizwa nge-eculizumab, esebenza ngendlela efanayo kakhulu. I-Eculizumab empeleni yayiwumuthi wokuqala walolu hlobo ovunyelwe i-PNH kanye ne-aHUS.

Inzuzo enkulu ye-ravulizumab ngaphezu kwe-eculizumab ukuthi ihlala isikhathi eside emzimbeni wakho, ngakho udinga ukufakwa ngokuphindaphindiwe. Nge-eculizumab, abantu ngokuvamile badinga ukwelashwa njalo ngemva kwamasonto ama-2, kuyilapho i-ravulizumab inganikezwa njalo ngemva kwamasonto ama-8.

Kwabanye abantu abane-PNH abanezimpawu ezithambile, ukunakekelwa okusekelayo njengokumpontshelwa igazi, izithasiselo zensimbi, kanye nemithi yokuvimbela ukujiya kwegazi kungasetshenziswa esikhundleni se-inhibitors yokugcwalisa.

Ukufakelwa komnkantsha wamathambo ngokwemfundiso kuyindlela yokwelapha i-PNH, kodwa akuvamile ukuthi kunconywe ngoba izingozi ngokuvamile ziphakeme kunezinzuzo, ikakhulukazi manje njengoba imithi esebenzayo efana ne-ravulizumab itholakala.

Udktela wakho uzokusiza uqonde ukuthi yiziphi izindlela zokwelapha ezifanele kakhulu isimo sakho esithile, ecabangela izimpawu zakho, impilo yonke, nezintandokazi zakho.

Ingabe i-Ravulizumab ingcono kune-Eculizumab?

I-Ravulizumab ne-eculizumab yomibili imithi esebenza kahle kakhulu esebenza ngendlela efanayo ukwelapha i-PNH ne-aHUS. Umehluko omkhulu ukuthi uvame kangakanani ukudinga ukuthola ukwelashwa.

Inzuzo enkulu ye-Ravulizumab ukulula. Ukuthola ukumnika njalo ngemva kwamasonto angu-8 esikhundleni samasonto angu-2 kusho ukuhamba okuncane esibhedlela noma emtholampilo, okungathuthukisa kakhulu izinga lempilo yakho futhi kwenze kube lula ukugcina umsebenzi nemisebenzi yomphakathi.

Mayelana nokusebenza kahle, yomibili imithi isebenza ngendlela efanayo ekumeni ukuhlakazeka kwamaseli abomvu egazi nokulawula izimpawu. Izifundo zibonisa ukuthi abantu abashintsha besuka ku-eculizumab beya ku-ravulizumab ngokuvamile bagcina izinga elifanayo lokulawulwa kwesifo.

Amaphrofayili emiphumela emibi nawo afana kakhulu phakathi kwemithi emibili. Zombili zithwala izingozi ezifanayo zokutheleleka okukhulu futhi zidinga izinyathelo zokuphepha ezifanayo nokuqapha.

Izindleko zingaba yinto okufanele icatshangelwe, njengoba yomibili imithi ibiza, kodwa umshwalense kanye nezinhlelo zokusiza iziguli ngokuvamile ziyatholakala kuzo zombili izinketho. Ithimba lakho lezempilo lingakusiza ukuthi uhambe ngalezi zinto ezicatshangelwayo zezezimali.

Imibuzo Evame Ukubuzwa Mayelana ne-Ravulizumab

Ingabe i-Ravulizumab iphephile kubantu abanezifo zenhliziyo?

I-Ravulizumab ngokuvamile ingasetshenziswa ngokuphepha kubantu abanezifo zenhliziyo, kodwa udokotela wakho wenhliziyo kanye nodokotela we-hematologist kuzodingeka basebenze ndawonye ukuze bakuqaphe ngokucophelela. Umuthi awuthinti ngokuqondile inhliziyo yakho, kodwa izimo eziyisisekelo ezilashwayo ngezinye izikhathi zingabangela izinkinga zenhliziyo.

Abantu abane-PNH basengozini enkulu yamaqhubu egazi, angathinta inhliziyo. Ngokulawula lesi sifo, i-ravulizumab ingase empeleni inciphise ingozi yakho yenhliziyo nemithambo yegazi. Kodwa-ke, odokotela bakho bazofuna ukukuqapha eduze nganoma yiziphi izinguquko ekusebenzeni kwenhliziyo yakho.

Uma unenhliziyo ehlulekayo enkulu noma ezinye izimo zenhliziyo ezinzima, ithimba lakho lezokwelapha lizohlola ngokucophelela izinzuzo nezingozi ngaphambi kokuqala i-ravulizumab. Bangase bafune ukuthuthukisa imithi yakho yenhliziyo kuqala noma banikeze ukuqapha okwengeziwe ngesikhathi sokwelashwa.

Kufanele Ngenzeni Uma Ngamukela Ngengozi I-Ravulizumab Eningi Kakhulu?

Ukweqisa kwe-ravulizumab akunakwenzeka ngoba umuthi unikezwa kuphela ochwepheshe bezempilo abaqeqeshiwe ezindaweni zezokwelapha ezilawulwayo. Ukulinganisa kubalwa ngokucophelela ngokususelwa esisindweni sakho nesimo sakho.

Uma ukhathazekile ngokuthi kungenzeka ukuthi uthole umthamo ongalungile, khuluma nethimba lakho lezempilo ngokushesha. Bangabuyekeza amarekhodi akho okwelashwa futhi bakuqaphe nganoma yiziphi izimpawu ezingavamile.

Esimeni esingavamile lapho othile ethola i-ravulizumab eningi kunaleyo ebihloswe, okuyinhloko okuzokhathazwa ngakho kungaba yingozi eyengeziwe yokutheleleka. Ithimba lakho lezokwelapha lizokuqapha eduze ngezimpawu zokutheleleka futhi lingase lincomise izinyathelo zokuphepha ezengeziwe.

Akukho umuthi oqondile we-ravulizumab, ngakho ukwelashwa kwanoma yikuphi ukweqisa kuzogxila ekuphatheni izimpawu nasekuvikeleni izinkinga ezinjengokutheleleka.

Kufanele Ngenzeni Uma Ngedlula Umthamo We-Ravulizumab?

Uma udlula ukumnika i-ravulizumab okuhleliwe, xhumana nethimba lakho lezempilo ngokushesha ngangokunokwenzeka ukuze uhlele kabusha. Kubalulekile ukungahambi isikhathi eside ngaphandle kokwelashwa, njengoba isimo sakho esingaphansi singase siphinde sisebenze.

Ngokuvamile, uma udlula i-aphoyintimenti yakho ngeminyaka embalwa nje, ungaqhubeka nje futhi uhlele kabusha futhi uqhubeke nohlelo lwakho lokwelashwa olujwayelekile. Kodwa-ke, uma udlule umthamo wakho ngaphezu kwesonto elilodwa noma amabili, udokotela wakho angase afune ukulungisa uhlelo lwakho olulandelayo lokulinganisa.

Ezimweni ezithile, ikakhulukazi uma ungathathi imithi amasonto amaningana, udokotela wakho angase ancome ukuqapha okwengeziwe noma ukuhlolwa kwegazi ngaphambi kokufakwa kwakho okulandelayo ukuze kuhlolwe ukuthi isimo sakho senzani.

Ungazami "ukulungisa" umthamo ophuthelwe ngokuphuza imithi eyengeziwe. Ithimba lakho lezempilo lizothola indlela engcono kakhulu yokukubuyisela emgqeni ngohlelo lwakho lokwelashwa.

Ngingayeka nini ukuthatha i-Ravulizumab?

Isinqumo sokuyeka i-ravulizumab kufanele senziwe ngaso sonke isikhathi ngokubonisana nethimba lakho lezempilo, njengoba ukuyeka ukwelashwa kungabangela ukuthi isimo sakho esingaphansi sibuyele ngokushesha. Abantu abaningi abane-PNH noma i-aHUS badinga ukuqhubeka nokwelashwa unomphela.

Noma kunjalo, zikhona izimo lapho udokotela wakho angase acabange ukuyeka noma ukumisa ukwelashwa. Lokhu kufaka phakathi izifo ezinzima ezingaphenduli emithini elwa namagciwane, ukusabela okukhulu komzimba, noma uma uthola ezinye izinkinga zempilo ezenza ukwelashwa okuqhubekayo kungaphephile.

Abanye abantu bangase bakwazi ukuphumula ekwelashweni uma benza kahle kakhulu, kodwa lesi sinqumo sidinga ukuqapha ngokucophelela futhi kufanele senziwe kuphela ngaphansi kokuqashwa kwezokwelapha okuseduze.

Uma ucabangela ukuyeka ukwelashwa ngenxa yemiphumela emibi noma ezinye izinkathazo, khuluma nethimba lakho lezempilo ngezixazululo ezingenzeka. Kwesinye isikhathi ukulungisa uhlelo lokulinganisa noma ukuphatha imiphumela emibi ngendlela ehlukile kungakusiza ukuthi uqhubeke nokwelashwa ngokuphepha.

Ngingahamba yini ngenkathi ngithatha i-Ravulizumab?

Yebo, ngokuvamile ungaqhubeka nohambo ngenkathi uthatha i-ravulizumab, kodwa uzodinga ukuhlela ngokucophelela ngohlelo lwakho lokufakwa futhi uthathe izinyathelo zokuphepha ezengeziwe ukuze uhlale unempilo. Abantu abaningi baphila impilo esebenzayo ngempumelelo ngenkathi besebenzisa lo muthi.

Ngaphambi kokuhamba, ikakhulukazi emazweni asathuthuka, xhumana nethimba lakho lezempilo mayelana nemithi yokugoma eyengeziwe noma izinyathelo zokuphepha ongase uzidinge. Ngenxa yokuthi i-ravulizumab yandisa ingozi yakho yokutheleleka, ungase udinge ukuvikelwa okwengeziwe ezifweni ezivamile ezindaweni ezithile.

Qiniseka ukuthi uletha imibhalo mayelana nesimo sakho kanye nemithi uma udinga ukunakekelwa kwezempilo ngenkathi uhamba. Ukuba nolwazi lokuxhumana nethimba lakho lezempilo kubalulekile futhi uma kuvela imibuzo.

Uma uhamba isikhathi eside, sebenzisana nethimba lakho lezempilo ukuze ulungiselele ukwelashwa lapho uya khona. Izikhungo eziningi ezinkulu zezokwelapha zingahlela ukunakekelwa kwabantu abasebenzisa imithi ekhethekile efana ne-ravulizumab.