I ka manawa hea kahi koho lāʻau biologic no ka maʻi o Crohn?

Anter

• He aha nā lāʻau biologic?
• ʻO nā ʻano biologics ʻekolu
• Nā lāʻau anti-TNF
• Nā mea kāohi interleukin
• Pākuʻi anti-integrin
• ʻO ka piʻi ʻana i luna a me ka hoʻoponopono luna kiʻekiʻe
• Nā hopena ʻaoʻao
• Nā manaʻo kūikawā
• Maʻi puʻu
• Nā maʻi ʻino
• Nā kūlana puʻuwai
• Nā pilikia ʻē aʻe

Hōʻike Overview

Hoʻokumu ka maʻi o Crohn i ka mumū, ka pehu ʻana, a me ka hoʻonāukiuki ʻana i ka uhi ʻana o ka tract digestive.

Inā ua hoʻāʻo ʻoe i nā lāʻau ʻē aʻe no ka maʻi o Crohn, a inā paha ua ʻike hou ʻia ʻoe, e noʻonoʻo paha kāu kauka i ke kau ʻana i nā lāʻau biologic. ʻO nā biologics nā lāʻau lapaʻau e kōkua i ka hoʻohaʻahaʻa ʻana i ka hoʻoweliweli ʻino mai ka maʻi o Crohn.

He aha nā lāʻau biologic?

Hoʻolālā ʻia nā biologics i nā lāʻau i hoʻomākaukau ʻia e kuhikuhi i kekahi mau mole i loko o ke kino e pili ana i ka hoʻonāukiuki

Kauoha pinepine nā kauka i nā biologics i ka poʻe me ka maʻi hōʻino ʻo Crohn e pane ʻole i nā lāʻau ʻē aʻe, a i ʻole i ka poʻe me nā ʻōuli koʻikoʻi.Ma mua o nā biologics, aia kekahi mau koho lapaʻau nonsurgical no ka poʻe me ka maʻi refactory.

Hana nā lāʻau biologic e lawe koke i ke kala. I loko o kahi manawa o ke kala ʻana, hele aku ka mumū a me nā ʻōpū o ka ʻōpū. Hiki ke hoʻohana ʻia nā Biologics ma kahi manawa lōʻihi e kōkua ai e mālama i nā wā o ke kala.

ʻO nā ʻano biologics ʻekolu

ʻO ke ʻano o ka biologic a kāu kauka e manaʻo ai e kaukaʻi i ka paʻakikī o kāu mau ʻōuli a me kahi o nā maʻi. ʻOkoʻa ka poʻe āpau. ʻOi aku ka maikaʻi o kahi lāʻau lāʻau olaola no kekahi ma mua o nā mea ʻē aʻe. Hiki paha iā ʻoe ke hoʻāʻo i kekahi mau lāʻau i mua o ka loaʻa ʻana o nā mea kūpono iā ʻoe.

ʻO nā lāʻau olaola no ka maʻi o Crohn i hāʻule i hoʻokahi o nā ʻāpana ʻekolu: anti-tumor necrosis factor (anti-TNF) therapies, interleukin inhibitors, and anti-integrin antibodies.

Hoʻopili nā anti-TNF therapies i kahi protein i pili i ka mumū. No ka maʻi o Crohn, hana nā anti-TNF therapies ma o ka pale ʻana i ka mumū i hoʻokumu ʻia e kēia protein i loko o nā ʻōpū.

Hana like nā mea hoʻopili interleukin, i ka pale ʻana i nā protein kūlohelohe e hoʻonāukiuki i nā ʻōpū. Pākuʻi nā anti-integrins i kekahi o nā ʻōnaehana pale ʻea e hoʻonā i ka wela.

Hāʻawi pinepine ʻia nā biologics i kahi subcutaneʻuʻala (me kahi nila ma o ka ʻili) a i ʻole intravenously (ma o ka IV tube). Hāʻawi ʻia lākou i kēlā me kēia ʻelua a ʻewalu paha pule, kaukaʻi ʻia i ka lāʻau. Pono ʻoe e hele i kahi haukapila a i ʻole kahi haukapila no ka hapa nui o kēia mau ʻano hana.

Ua ʻae ʻo FDA i kekahi mau lāʻau olaola e mālama i ka maʻi o Crohn.

Nā lāʻau anti-TNF

• adalimumab (Humira, Exemptia)
• certolizumab pegol (Cimzia)
• infliximab (Remicade, Remsima, Inflectra)

Nā mea kāohi interleukin

• ustekinumab (Stelara)

Pākuʻi anti-integrin

• natalizumab (Tysabri)
• vedolizumab (Entyvio)

ʻO ka piʻi ʻana i luna a me ka hoʻoponopono luna kiʻekiʻe

Hiki i nā lāʻau hoʻomalu biologic ke lilo i mea hana ikaika i ka mālama ʻana a me ka mālama ʻana i ka maʻi o Crohn. Aia ʻelua ʻano ʻokoʻa i ka biologic therapy:

• ʻO ka step-up therapy ka ala maʻamau a hiki i ka hoʻokuʻu ʻia ʻana o nā kulekele hou i ka makahiki 2018. ʻO kēia ala ke ʻano ʻo ʻoe a me kāu kauka e hoʻāʻo i nā ʻano lapaʻau ʻē aʻe ma mua o ka hoʻomaka ʻana i kahi biologic.
• ʻO ka hoʻomaʻamaʻa top-down ʻo ia hoʻi ka hoʻomaka mua ʻana o nā lāʻau biologic i ke kaʻina hana. ʻO kēia ke ala i makemake ʻia i nā manawa he nui o ka maʻi kaulike a koʻikoʻi a Crohn.

Eia nō naʻe, ʻoi aku ka maikaʻi o nā ala like ʻole no nā poʻe like ʻole e pili ana i ka paʻakikī a me kahi o ka maʻi.

Nā hopena ʻaoʻao

Mālama ʻo Biologics i nā hopena ʻē aʻe i ʻoi aku ka paʻakikī ma mua o nā lāʻau maʻi Crohn, e like me nā corticosteroids, ka mea e kaomi i ka ʻōnaehana pale āpau.

Eia nō naʻe, aia kekahi mau hopena ʻaoʻao āu e ʻike ai ma mua o ka lawe ʻana i kahi lāʻau biologic.

ʻO kekahi mau hopena ʻaoʻao maʻamau o nā biologics:

• ʻulaʻula, aniani, ʻōpala, ʻeha, a ʻōpala paha a puni ka pūnaewele injection
• ʻeha poʻo
• ke kunu a i ʻole ke anuanu
• paʻakikī i ka hanu ʻana
• haʻahaʻa haʻahaʻa haʻahaʻa
• hives a wīwī paha
• ʻeha ka ʻōpū
• ʻeha kua
• nausea
• ʻeha a ʻeha ʻeha paha

Nā manaʻo kūikawā

ʻAʻole palekana ʻo Biologics no nā mea āpau. E kamaʻilio me kāu kauka inā loaʻa ʻoe i ka maʻi puʻu (TB), maʻalahi i nā maʻi, a i ʻole he maʻi puʻuwai.

Maʻi puʻu

ʻO nā lāʻau biologic i hoʻohana ʻia no ka maʻi o Crohn hiki ke hoʻonui i ka makaʻu o ka hoʻoulu hou ʻana i kahi maʻi tuberculosis i ka poʻe i wehe ʻia. He maʻi kūpilikiʻi nui ʻo TB.

Pono kāu kauka e hoʻāʻo iā ʻoe no ka TB ma mua o ka hoʻomaka ʻana o ka hoʻōla me kahi biologic. Hiki ke hiamoe kahi maʻi TB i ke kino. ʻAʻole paha ʻike kekahi poʻe i kū i ka maʻi.

Inā ua ʻike mua ʻoe i ka TB, hiki i kāu kauka ke koi aku i ka mālama ʻana i ka TB ma mua o ka lawe ʻana i kahi biologic.

Nā maʻi ʻino

Hiki i nā biologics ke hoʻohaʻahaʻa i ka hiki i ke kino ke hakakā i nā maʻi ʻē aʻe. Inā maʻalahi ʻoe i nā maʻi, hiki i kāu kauka ke ʻōlelo i kekahi ʻano ʻano lāʻau ʻē aʻe.

Nā kūlana puʻuwai

Kūpono paha nā lāʻau anti-TNF no ka poʻe me kekahi ʻano puʻuwai, e like me ka maikaʻi ʻole o ka puʻuwai. ʻO ka puʻuwai puʻuwai ke hiki ʻole i ka puʻuwai ke pauma i ke koko e lawa ai nā pono o ke kino.

E haʻi koke i kāu kauka inā ʻike ʻoe i ka pōkole o ka hanu a i ʻole ka pehu ʻana o nā wāwae ke lawe ʻoe i kahi biologic no ka maʻi o Crohn. He hōʻailona paha kēia o ka holo pono ʻole o ka naʻau.

Nā pilikia ʻē aʻe

Hoʻohui ʻia kekahi manawa nā lāʻau biologic me nā pilikia olakino koʻikoʻi. I ka poʻe e lawe nei i nā lāʻau biologic, ʻaʻole hōʻike pinepine ʻia nā pilikia olakino e hiki mai ana.

• kekahi mau maʻi koko (bruising, Blood)
• nā pilikia neurological (e like me, numbness, nāwaliwali, tingling, a i ʻole nā ​​haunaele ʻike, e like me ka ʻike maka ʻole, ʻike ʻelua, a i ʻole nā ​​makapō hapa)
• lymphoma
• hōʻino ka ate
• nā hopena maʻi ʻino nui

E kamaʻilio me kāu kauka e hoʻoholo i ka ʻoi loa o ka therapy no ʻoe a me kāu mau pono.