ʻO Rituxan Infusion no ka Rheumatoid Artritis: He aha ka mea e manaʻo ai

Anter

• Hōʻike Overview
• ʻO wai ka moho maikaʻi no kēia lapaʻau?
• He aha ka ʻōlelo a ka noiʻi?
• Pehea e hana ai ʻo Rituxan no RA?
• He aha ka mea e manaʻo ai i ka wā o ka infusion
• He aha nā hopena?
• ʻO ka lawe lawe ʻana

Hōʻike Overview

ʻO Rituxan kahi lāʻau biologic i ʻae ʻia e ka mea i ʻae ʻia e ka US Food and Drug Administration (FDA) i ka makahiki 2006 e mālama ai i ka rheumatoid arthritis (RA). ʻO rituximab kona inoa nui.

ʻO ka poʻe me RA i pane ʻole i nā ʻano lapaʻau ʻē aʻe e hoʻohana iā Rituxan me ka hui pū me ka methotrexate lāʻau.

ʻO Rituxan kahi wai kala ʻole i hāʻawi ʻia e ka infusion. ʻO kahi mea ʻenekini genetically engineered e pahuhopu nei i nā hunaola B i pili i ka mumū RA. Ua ʻae pū ka FDA iā Rituxan no ka lymphoma non-Hodgkin, leukemia lymphocytic mau, a me ka granulomatosis me ka polyangiitis.

ʻO ka rituximab a me ka methotrexate, kahi suppressor ʻōnaehana pale, i hoʻomohala mua ʻia a hoʻohana ʻia e like me nā lāʻau anticancer. Hoʻokumu ʻia ʻo Rituxan e Genentech. Ma ʻEulopa, kūʻai ʻia ʻo MabThera.

ʻO wai ka moho maikaʻi no kēia lapaʻau?

Ua ʻae ka FDA i ka mālama ʻana me Rituxan a me methotrexate:

• inā he kaulike a paʻakikī RA ʻoe
• inā ʻaʻole ʻoe i pane maikaʻi i ka mālama ʻana me nā mea keʻakeʻa no nā mea pono ʻiʻi tumrosis (TNF)

Kūkākūkā ka FDA e hoʻohana ʻia ʻo Rituxan i ka wā hāpai wale nō ke ʻoi aku ka pōmaikaʻi i ka makuahine ma mua o ka nui o ka pilikia i ke keiki hānau ʻole. ʻO ka palekana o ka hoʻohana ʻana o Rituxan me nā keiki a i ʻole nā ​​makuahine hānai ʻaʻole i hoʻokumu ʻia.

Paipai ʻo FDA e kūʻē i ka hoʻohana ʻana o Rituxan no ka poʻe me RA i mālama ʻole ʻia me hoʻokahi a ʻoi paha nā mea keʻakeʻa no TNF.

ʻAʻole nō hoʻi e koi ʻia ʻo Rituxan no ka poʻe i loaʻa i ka maʻi hepatitis B a i ʻole hāpai i ka maʻi, no ka mea hiki iā Rituxan ke hoʻoulu hou i ka maʻi hepatitis B.

He aha ka ʻōlelo a ka noiʻi?

ʻO ka maikaʻi o rituximab i kahi noiʻi noiʻi. Ua ukali ʻia nā hoʻokolohua hoʻokolohua ʻē aʻe.

ʻO ka ʻae ʻia o ka hoʻohana ʻana ʻo Rituxan no ka RA ma muli o ʻekolu mau noiʻi makapō pālua i hoʻohālikelike ʻia me rituximab a me methotrexate lapaʻau me kahi placebo a me methotrexate.

ʻO kekahi o nā noiʻi noiʻi he makahiki ʻelua i hoʻopaʻa ʻia i hoʻopaʻa ʻia i kapa ʻia ʻo REFLEX (Randomised Evaluation of Long-Term Efficacy of Rituximab in RA).Ua ana ʻia ka maikaʻi me ka hoʻohana ʻana i ka loiloi o ka American College of Rheumatology (ACR) o ka hoʻomaikaʻi ʻana i ka palupalu a me ka pehu.

ʻO ka poʻe i loaʻa ka rituximab i ʻelua mau infusions, ʻelua pule kaawale. Ma hope o 24 mau pule, ua loaʻa ʻo REFLEX i:

• 51 pakeneka o ka poʻe i mālama ʻia me rituximab me 18 pākēneka i mālama ʻia me kahi placebo hōʻike i kahi hoʻomaikaʻi o ACR20
• 27 pakeneka o ka poʻe i mālama ʻia me rituximab a me 5 pākēneka o ka poʻe i mālama ʻia me kahi placebo hōʻike i kahi hoʻomaikaʻi o ACR50
• 12 pakeneka o ka poʻe i mālama ʻia me rituximab me 1 pakeneka o ka poʻe i mālama ʻia me kahi placebo hōʻike i kahi hoʻomaikaʻi o ACR70

ʻO nā helu ACR ma aneʻi e nānā i ka hoʻomaikaʻi ʻana mai nā hōʻailona RA baseline.

Ua hoʻomaikaʻi nui ka poʻe me rituximab i nā ʻōuli ʻē aʻe e like me ka luhi, kīnā ʻole, a me ke ʻano o ke ola. Ua hōʻike pū nā kukuna X i kahi kū i ka hoʻoliʻiliʻi hui liʻiliʻi.

ʻO kekahi poʻe i ke aʻo ʻana ua loaʻa nā hopena ʻaoʻao, akā ʻo kēia mau mea akahai a ʻano kaulike.

mai ka 2006 ua loaʻa nā pono like me ka lapaʻau me rituximab a me methotrexate.

Pehea e hana ai ʻo Rituxan no RA?

ʻO ka hana no ka pono o rituximab i ka mālama ʻana iā RA a me nā maʻi ʻē aʻe. Manaʻo ʻia e kuhi nā mea pale mūlū rituximab i kahi mole (CD20) ma luna o kekahi mau hunaola B e pili pū me ke kaʻina o ka mumuna RA Manaʻo ʻia kēia mau hunaola B e pili pū me ka hana ʻana i ka mea rheumatoid (RF) a me nā mea ʻē aʻe e pili ana i ka pehu.

ʻIke ʻia ʻo Rituximab i kahi manawa pōkole akā hoʻopau piha o nā hunaola B i ke koko a me kahi hapa o ka iwi o ka iwi a me kaʻiʻo. Akā ulu hou kēia mau pūnaewele B i. Pono paha kēia i ka hoʻomau ʻana i ka rīximab infusion.

Ke hoʻomau nei ka noiʻi e noiʻi pehea e hana ai nā rituximab a me nā pūnaewele B ma RA.

He aha ka mea e manaʻo ai i ka wā o ka infusion

Hāʻawi ʻia ʻo Rituxan e kahi kulu i loko o kahi aa (infravenous infusion, a i ʻole IV) i kahi hoʻonohonoho maʻi. ʻO ke ana he ʻelua mau infusions 1,000-milligram (mg) i hoʻokaʻawale ʻia e nā pule ʻelua. ʻAʻole ʻeha ka infusion Rituxan, akā hiki paha iā ʻoe ke loaʻa kahi ʻano ʻākena i ka lāʻau.

E nānā kāu kauka i kou olakino laulaha ma mua o ka hāʻawi ʻana i ka lāʻau a nānā iā ʻoe i ka wā o ka infusion.

ʻO ka hapalua hola ma mua o ka hoʻomaka ʻana o ka infusion Rituxan, e hāʻawi ʻia ʻoe i ka infusion o 100 mg o methylprednisolone a i ʻole steroid like a me ka antihistamine a me acetaminophen (Tylenol) paha. Paipai ʻia kēia e kōkua i ka hōʻemi ʻana i nā hopena i ka infusion.

E hoʻomaka lohi kāu infusion mua ma kahi o 50 mg i kēlā me kēia hola, a e hoʻomau ke kauka i ka hōʻoia ʻana i kāu mau hōʻailona koʻikoʻi e hōʻoia ʻaʻole ʻoe i loaʻa i kahi hopena maikaʻi ʻole i ka infusion.

ʻO ka hana hoʻoulu mua e lawe ma kahi o 4 mau hola a 15 mau minuke. ʻO ka pīpī ʻana i ka ʻeke me kahi hopena e hōʻoia e loaʻa iā ʻoe ka nui o Rituxan i 15 mau minuke.

Pono kāu lua o ka hoʻomaʻemaʻe infusion i hoʻokahi hola ma lalo o hoʻokahi hola.

He aha nā hopena?

I nā hoʻokolohua hoʻokolohua o Rituxan no RA, ma kahi o 18 pākēneka o nā kānaka i loaʻa nā hopena ʻaoʻao. ʻO nā hopena ʻaoʻao maʻamau, ʻike ʻia i ka manawa a 24 mau hola ma hope o ka hoʻopili ʻana,

• ʻāʻī puʻupuʻu ʻāʻī
• nā ʻōuli like flu
• hūwī
• ʻumeʻume
• ʻūpā
• ʻeha kua
• hoʻohuhū ʻōpū
• nausea
• ka houʻu ʻana
• ʻoʻoleʻa o ka mākala
• hopohopo
• ʻōlohelohe

ʻO ka maʻa mau o ka lāʻau steroid a me ka antihistamine e loaʻa iā ʻoe ma mua o ka hoʻohaʻahaʻa ʻana e hoʻemi i ke koʻikoʻi o kēia mau hopena ʻaoʻao.

Inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi ʻoi aku, kāhea i kāu kauka. Pākuʻi ʻia kēia mau mea:

• nā maʻi maʻi hanu o luna
• he anu
• maʻi maʻi urinary tract
• bronchitis

Kāhea koke i kāu kauka inā ʻike ʻoe i nā loli o ka hihiʻo, huikau, a i ʻole ka lilo o ke kaulike. Kākaʻikahi nā hopena koʻikoʻi iā Rituxan.

ʻO ka lawe lawe ʻana

Ua ʻae ʻia ʻo Rituxan (generic rituximab) no ka hoʻomaʻamaʻa RA mai 2006. Ma kahi o 1 i 3 mau kānaka i mālama ʻia no RA ʻaʻole e pane kūpono i nā ʻano lāʻau biologic ʻē aʻe. No laila hāʻawi ʻo Rituxan i kahi koho kūpono. E like me ka 2011, ʻoi aku ka nui o ka 100,000 poʻe me RA ma ka hona holoʻokoʻa i loaʻa i ka rituximab.

Inā ʻoe he moho no Rituxan, e heluhelu e pili ana i kona hopena i hiki ai iā ʻoe ke hoʻoholo i ka hoʻoholo. Pono ʻoe e kaulike i nā pono a me nā pōpilikia kūpono me nā mālama ʻē aʻe (e like me minocyline a i ʻole nā ​​lāʻau hou i ka hoʻomohala). Kūkākūkā i kāu koho koho lāʻau lapaʻau me kāu kauka.