I-minocycline ye-Rheumatoid Arthritis: Ingabe Iyasebenza?

-Delile

• Mayelana nokusetshenziswa kwezidakamizwa ezingekho kwelebula
• Uthini ucwaningo?
• Umlando wokuqala wocwaningo
• Amaphuzu avelele ezifundo nge-minocycline
• Ngabe i-minocycline isebenza kanjani ukuphatha i-RA?
• Ngubani ongazuza kwiminocycline yeRA?
• Yini umthetho olandelwayo?
• Iyini imiphumela emibi?
• Ukuthatha

Ukubuka konke

IMinocycline iyi-antibiotic emndenini we-tetracycline. Isetshenziselwe okungaphezu kokulwa nezifo ezahlukahlukene.

, Abaphenyi bakhombise izakhiwo zayo ezilwa nokuvuvukala, ezokuzivikela ezifweni, nezokuvikela izinzwa.

Kusukela i-rheumatologists isebenzise ngempumelelo i-tetracyclines ye-rheumatoid arthritis (RA). Lokhu kufaka i-minocycline. Lapho kutholakala amakilasi amasha emithi, ukusetshenziswa kwe-minocycline kwehla. Ngasikhathi sinye, kukhombisile ukuthi i-minocycline ilusizo kuRA.

I-Minocycline ayivunyelwe ngokuqondile yi-U.S. Food and Drug Administration (FDA) ukuze isetshenziswe neRA. Inikezwa ngezikhathi ezithile "okungekho kwelebula."

Naphezu kwemiphumela yayo ezuzisayo ezivivinyweni, i-minocycline ngokuvamile ayisetshenziselwa ukwelapha i-RA namuhla.

Mayelana nokusetshenziswa kwezidakamizwa ezingekho kwelebula

Ukusetshenziswa kwezidakamizwa ezingekho kwelebula kusho ukuthi umuthi ovunyelwe yi-FDA ngenhloso eyodwa usetshenziselwa injongo eyehlukile engavunyelwe. Kodwa-ke, udokotela usengasisebenzisa lesi sidakamizwa ngaleyo njongo. Lokhu kungenxa yokuthi i-FDA ilawula ukuhlolwa nokuvunywa kwezidakamizwa, kodwa hhayi ukuthi odokotela bazisebenzisa kanjani izidakamizwa ukwelapha iziguli zabo. Ngakho-ke udokotela wakho angakunika umuthi kodwa bacabanga ukuthi ungcono kakhulu ukunakekelwa kwakho. Funda kabanzi ngokusetshenziswa kwezidakamizwa ezingekho kwelebula.

Uthini ucwaningo?

kusukela ngasekupheleni kweminyaka yama-1930 ukuthi amabhaktheriya ayabandakanyeka ekudaleni i-RA.

Ucwaningo lomtholampilo nolulawulwayo lokusetshenziswa kwe-minocycline yeRA ngokujwayelekile luphetha ngokuthi i-minocycline inenzuzo futhi iphephe kakhulu kubantu abane-RA.

Amanye ama-antibiotic ahlanganisa ama-sulfa compounds, amanye ama-tetracyclines, ne-rifampicin. Kepha i-minocycline ibe yisihloko sezifundo ezingaboni kabili nokuhlolwa kwemitholampilo ngenxa yezakhiwo zayo ezibanzi.

Umlando wokuqala wocwaningo

Ngo-1939, isazi se-rheumatologist saseMelika uThomas McPherson-Brown nozakwabo bahlukanisa umuthi webhaktheriya onjengegciwane ezicutshini zeRA. Bayibiza ngokuthi i-mycoplasma.

Kamuva uMcPherson-Brown waqala ukwelashwa kokuhlola kwe-RA ngama-antibiotic. Abanye abantu baqale baba babi kakhulu. UMcPherson-Brown uthe lokhu kubangelwe yiHerxheimer, noma “ukufa”: Lapho amabhaktheriya ehlaselwa, akhipha ubuthi obuqale bube nezimpawu zezifo. Lokhu kubonisa ukuthi ukwelashwa kuyasebenza.

Esikhathini eside, iziguli sezingcono. Abaningi bathole ukuxolelwa ngemuva kokuphuza i-antibiotic kuze kube yiminyaka emithathu.

Amaphuzu avelele ezifundo nge-minocycline

Izifundo eziyi-10 ziqhathanisa i-tetracycline antibiotic nokwelashwa okuvamile noma i-placebo ene-RA. Ucwaningo luphethe ngokuthi ukwelashwa kwe-tetracycline (futhi ikakhulukazi i-minocycline) kwakuxhunywe ekuthuthukisweni okwakubaluleke kakhulu emtholampilo.

Ucwaningo olulawulwa nge-1994 lwe-minocycline olunabahlanganyeli abangama-65 lubike ukuthi i-minocycline ibilusizo kulabo abane-RA esebenzayo. Iningi labantu kulolu cwaningo belithuthukile i-RA.

Abantu abangu-219 abane-RA baqhathanisa ukwelashwa ne-minocycline ne-placebo. Abaphenyi baphetha ngokuthi i-minocycline yayisebenza futhi iphephile ezimweni ezimaphakathi nezincane ze-RA.

Ucwaningo lwango-2001 lwabantu abangama-60 abane-RA baqhathanisa ukwelashwa ne-minocycline ne-hydroxychloroquine. I-Hydroxychloroquine yisidakamizwa esishintsha isifo esinciphisa isifo (i-DMARD) esivame ukusetshenziswa ukwelapha i-RA. Abaphenyi bathi i-minocycline yayisebenza kangcono kunama-DMARD we-RA yokuqala engaconsi phansi.

Ukulandelwa kweminyaka emine kubheke iziguli ezingama-46 ocwaningweni oluyimpumputhe kabili oluqhathanisa ukwelashwa ne-minocycline ne-placebo. Iphinde yaphakamisa ukuthi i-minocycline iyindlela yokwelapha esebenzayo ye-RA. Abantu abaphathwe nge-minocycline babenama-remissions ambalwa futhi badinga ukwelashwa kwendabuko okuncane. Lokhu bekunjalo yize inkambo ye-minocycline ibiyizinyanga ezintathu kuya kweziyisithupha nje.

Kubalulekile ukuqaphela ukuthi eziningi zalezi zifundo zazibandakanya ukusetshenziswa kwesikhashana kwe-minocycline. UMcPherson-Brown ugcizelele ukuthi indlela yokwelashwa yokuthola ukuxolelwa noma ukwenziwa ngcono okuphawulekayo ingathatha iminyaka emithathu.

Ngabe i-minocycline isebenza kanjani ukuphatha i-RA?

Indlela eqondile yeminocycline njengokwelashwa kweRA ayiqondakali kahle. Ngaphezu kwesenzo semithi elwa namagciwane, i-minocycline inezinto ezilwa nokuvuvukala. Ngokuqondile, minocycline ku:

• kuthinta i-nitric oxide synthase, ebandakanyeka ekonakaleni kwe-collagen
• thuthukisa i-interleukin-10, evimbela i-cytokine evimbela ukuvuvukala kwezicubu ze-synovial (izicubu ezixhumanayo ezizungeze amalunga)
• cindezela ukusebenza kwamaseli we-B no-T

IMinocycline ingaba ne-. Lokhu kusho ukuthi kungathuthukisa ukwelashwa kwe-RA uma kuhlanganiswe nemithi engeyona yokulwa nokuvuvukala noma eminye imithi.

Ngubani ongazuza kwiminocycline yeRA?

Kuphakanyiswa ngokuthi abaqokelwe phambili kakhulu yilabo abasesigabeni sokuqala se-RA. Kepha olunye ucwaningo lukhombisa ukuthi abantu abane-RA ethuthuke kakhulu bangahlomula nabo.

Yini umthetho olandelwayo?

Inqubo ejwayelekile yezidakamizwa ezifundweni zocwaningo ngama-milligram ayi-100 (mg) kabili ngosuku.

Kepha umuntu ngamunye wehlukile, futhi iphrothokholi ye-minocycline ingahluka. Abanye abantu bangadinga ukuqala ngomthamo ophansi futhi basebenze kuze kufike ku-100 mg noma ngaphezulu kabili ngosuku. Abanye bangadinga ukulandela uhlelo olushaywayo, bathathe i-minocycline izinsuku ezintathu ngesonto noma bayishintshe nezinye izidakamizwa.

Njengokwelashwa kwama-antibiotic kwesifo seLyme, ayikho indlela yobukhulu obulingana nayo yonke indlela. Futhi, kungathatha iminyaka emithathu ukubona imiphumela kwezinye izimo ze-RA.

Iyini imiphumela emibi?

IMinocycline ivame ukubekezelelwa kahle. Imiphumela emibi engaba khona ilinganisiwe futhi iyafana neyeminye imithi elwa namagciwane. Kubandakanya:

• izinkinga zamathumbu
• isiyezi
• ikhanda
• ukuqubuka kwesikhumba
• ukwanda kokuzwela ekukhanyeni kwelanga
• imvubelo yesifo sangasese sowesifazane
• okweqile

Ukuthatha

IMinocycline, esetshenziswa ikakhulukazi isikhathi eside, ikhonjisiwe ukuthi ithuthukise izimpawu ze-RA nokusiza ukufaka abantu ekuxolelweni. Ayisetshenziswa kabanzi namuhla, ngaphandle kwerekhodi layo eliqinisekisiwe.

Izimpikiswano ezijwayelekile ezinikezwe ukusetshenziswa kwe-minocycline ye-RA yilezi:

• Azikho izifundo ezanele.
• Ama-antibiotic anemiphumela engemihle.
• Ezinye izidakamizwa zisebenza kangcono.

Abanye abacwaningi nama-rheumatologists abavumelani nalezi zingxabano futhi bakhomba imiphumela yezifundo ezikhona.

Kubalulekile ukubamba iqhaza ekuhleleni ukwelashwa kwakho futhi ucwaninge ngezinye izindlela. Xoxa nodokotela wakho okungakuhle kakhulu esimweni sakho.

Uma ungathanda ukuzama i-minocycline futhi udokotela wakho akayeki, buza ukuthi kungani. Khombisa umlando obhaliwe wokusetshenziswa kwe-minocycline. Khuluma nodokotela ngemiphumela emibi yokuthatha i-steroids isikhathi eside uma kuqhathaniswa nemiphumela emibi kakhulu ye-minocycline. Ungahle ufune ukubheka isikhungo sokucwaninga esisebenze ne-minocycline ne-RA.