Ukwelashwa Okusha Kwe-Rheumatoid Arthritis kanye Nezifundo: Ucwaningo Lwakamuva

-Delile

• Ama-JAK inhibitors anikeza usizo
• I-BTK inhibitor ekukhuleni
• I-Neurostimulation ikhombisa isithembiso
• Ama-omega-3 fatty acids angasiza
• Imithi ye-RA exhunywe nezinzuzo zezempilo yenhliziyo
• Ukuthatha

I-rheumatoid arthritis (RA) yisimo esingelapheki esidala ukuvuvukala kwamalunga, ukuqina nobuhlungu. Alikho ikhambi elaziwayo le-RA - kodwa kunezindlela zokwelapha ezitholakalayo zokusiza ukukhulula izimpawu, ukunciphisa ukulimala okuhlangene, nokukhuthaza impilo enhle jikelele.

Njengoba ososayensi beqhubeka nokwakha nokwenza ngcono ukwelashwa kwe-RA, udokotela wakho angancoma ushintsho kuhlelo lwakho lokwelashwa.

Funda ukuze ufunde ngolunye ucwaningo lwamuva nezindlela zokwelashwa ezintsha zalesi simo.

Ama-JAK inhibitors anikeza usizo

Abantu abaningi abane-RA basebenzisa uhlobo lwesidakamizwa esiguqula isifo i-antirheumatic (DMARD) esaziwa njenge-methotrexate. Kepha kwezinye izimo, ukwelashwa nge-methotrexate kukodwa akwanele ukulawula izimpawu.

Uma ngabe ubuthatha i-methotrexate futhi usabhekene nezimpawu ezimaphakathi nezimbi ze-RA, udokotela wakho angancoma ukuthi ungeze i-janus kinase (JAK) inhibitor ohlelweni lwakho lokwelashwa. Ama-JAK inhibitors asiza ukumisa ukusabela kwamakhemikhali okubangela ukuvuvukala emzimbeni wakho. IMethotrexate iyakwenza lokhu, nayo, kodwa ngendlela ehlukile. Kwabanye abantu, ama-JAK inhibitors asebenza ngempumelelo enkulu.

Kuze kube manje, i-Food and Drug Administration (i-FDA) isivume izinhlobo ezintathu ze-JAK inhibitors ukwelapha i-RA:

• i-tofacitinib (Xeljanz), yamukelwa ngo-2012
• baricitinib (Olumiant), ivunyelwe ngo-2018
• upadacitinib (Rinvoq), ivunyelwe ngo-2019

Abaphenyi bayaqhubeka nokutadisha le mithi ukuze bafunde ukuthi baqhathanisa kanjani, nakwezinye izindlela zokwelashwa. Isibonelo, ososayensi muva nje bathole ukuthi inhlanganisela ye-methotrexate ne-upadacitinib ibisebenza kangcono kune-methotrexate ne-adalimumab yokwehlisa ubuhlungu nokwenza ngcono ukusebenza kwabantu abane-RA. Bangaphezu kuka-1 600 abantu abane-RA ababambe iqhaza kulolu cwaningo.

Ukuhlolwa komtholampilo nakho kuyaqhubeka ukwakha ama-JAK inhibitors amasha, kufaka phakathi umuthi wokuhlola owaziwa nge-filgotinib. Esivivinyweni somtholampilo sesigaba III sakamuva, i-filgotinib itholakale isebenza kangcono kune-placebo yokwelapha i-RA kubantu abake bazama i-DMARD eyodwa noma amaningi ngaphambilini. Ucwaningo olwengeziwe luyadingeka ukutadisha ukuphepha nokusebenza isikhathi eside kwalesi sidakamizwa sokuhlola.

Ukuze ufunde kabanzi ngezinzuzo nezingozi zokuthatha i-JAK inhibitor, khuluma nodokotela wakho. Bangakusiza ufunde ukuthi ngabe lolu hlobo lomuthi lungahle lube ukukhetha okuhle kuwe.

I-BTK inhibitor ekukhuleni

I-Bruton's tyrosine kinase (BTK) iyi-enzyme ebamba iqhaza ekuthuthukiseni ukuvuvukala. Ukuvimba isenzo se-BTK, abacwaningi bebelokhu besungula futhi behlola i-BTK inhibitor eyaziwa njenge-fenebrutinib.

Izifundo zakuqala ziphakamisa ukuthi i-fenebrutinib ingahlinzeka ngenye indlela yokwelashwa ye-RA. Iqembu lomhlaba wonke labaphenyi lisanda kuqeda ukuhlolwa komtholampilo wesigaba II ukutadisha ukuphepha nokusebenza kwe-fenebrutinib ekwelapheni lesi simo. Bathole ukuthi i-fenebrutinib ibiphephe ngokwamukelekayo futhi isebenza ngempumelelo.

Ucwaningo luthole ukuthi lapho kuhlanganiswa ne-methotrexate, i-fenebrutinib yayisebenza kangcono kune-placebo yokwelapha izimpawu ze-RA. I-Fenebrutinib ibinamazinga wokusebenza afanayo njenge-adalimumab.

Ucwaningo oluningi luyadingeka ukutadisha ukuphepha nokusebenza kwe-fenebrutinib.

I-Neurostimulation ikhombisa isithembiso

Abanye abantu bazama imishanguzo eminingi yokwelapha i-RA, ngaphandle kwempumelelo.

Njengenye indlela yokwelashwa, abacwaningi bafunda izinzuzo ezingaba khona nezingozi zokugqugquzelwa kwemizwa ye-vagus ekwelapheni i-RA. Kule ndlela yokwelashwa, kusetshenziswa imizwa kagesi ukukhuthaza imizwa ye-vagus. Le nzwa isiza ukulawula ukuvuvukala emzimbeni wakho.

Ososayensi muva nje benze isifundo sokuqala somuntu sokushayela indiza se-vagus nerve ekwelapheni i-RA. Bafaka i-neurostimulator encane noma umshini wokukhohlisa kubantu abangu-14 abane-RA. Abayisithupha balabo bantu baphathwa nge-vagus nerve stimulation kanye ngosuku amasonto ayi-12.

Phakathi kwabahlanganyeli abathola ukuvuselelwa kwansuku zonke kwe-vagus nerve, ababambiqhaza abane kwabayisithupha babone ukuthuthuka ezimpawu ze-RA. Ababambiqhaza abambalwa bahlangabezana nezehlakalo ezimbi ngesikhathi sokwelashwa, kepha akukho neyodwa imicimbi ebikiwe ebibucayi noma ingunaphakade.

Ama-omega-3 fatty acids angasiza

Ngaphezu kokuthatha imishanguzo oyinikiwe, ucwaningo lukhombisa ukuthi ukufaka isengezo se-omega-3 enkambisweni yakho yansuku zonke kungasiza ekunciphiseni izimpawu ze-RA.

Ukusetshenziswa kwe-Omega-3 fatty acid kuye kwaxhunyaniswa nokuncipha kokuvuvukala emzimbeni. Lapho abaphenyi abavela eNyuvesi yaseHouston bebuyekeza ucwaningo olwenziwe nge-omega-3 supplementation, bathola izivivinyo zokwelashwa ezingama-20 ezazigxile ku-RA ikakhulukazi. Ezilingweni eziyi-16 kwezingu-20, ukwesekwa kwe-omega-3 kwaxhunyaniswa nokuthuthuka okukhulu kwezimpawu ze-RA.

Ucwaningo lwakamuva lokuthola lubuye lwathola ukuxhumana phakathi kokuxhaswa kwe-omega-3 nokunciphisa umsebenzi wezifo kubantu abane-RA. Emhlanganweni Wonyaka Wonyaka we-2019 ACR / ARP, abacwaningi babike imiphumela yocwaningo lobude besikhathi eside lwabantu abangu-1,557 abane-RA. Ababambiqhaza ababike ukuthi bathatha izithasiselo ze-omega-3 babenezibalo zemisebenzi yezifo eziphansi, amalunga angavuvukalanga, kanye namalunga angabi buhlungu ngokwesilinganiso kunalabo abangathathanga izithako ze-omega-3.

Imithi ye-RA exhunywe nezinzuzo zezempilo yenhliziyo

Imithi ethile ye-RA ingaba nezinzuzo ngenhliziyo yakho, kanye nasemalungeni akho. Ngokwezifundo ezimbili ezintsha ezethulwe eMhlanganweni Wonyaka Wonyaka we-2019 ACR / ARP, leyo mithi ifaka phakathi i-methotrexate ne-hydroxychloroquine.

Kokunye ukuhlola, abaphenyi balandela omakadebona abangama-2,168 abane-RA kusuka ngo-2005 kuya ku-2015. Bathola ukuthi ababambiqhaza abathole ukwelashwa nge-methotrexate babencane amathuba okuthi bahlangabezane nezehlakalo zenhliziyo, njengokuhlaselwa yinhliziyo noma isifo sohlangothi. Ababambiqhaza abathole i-methotrexate nabo babencane amathuba okuthi balaliswe esibhedlela ngenxa yokwehluleka kwenhliziyo.

Kokunye ukuhlola, abacwaningi baseCanada bahlaziya idatha yokubhalisa eqoqwe emaqenjini amathathu: abantu abane-RA, abantu abane-systemic lupus erythematosus (SLE), nezilawuli ezinempilo ezingenasimo. Abantu abane-RA noma i-SLE abelashwa nge-hydroxychloroquine babe nengozi encishisiwe yemicimbi yenhliziyo, efana nokuhlaselwa yisifo senhliziyo noma isifo sohlangothi.

Ukuthatha

Ukuphumelela kwesayensi yezokwelapha kungasiza futhi abacwaningi ukuthi basebenzise izindlela zokwelashwa ezikhona futhi bathuthukise izindlela ezintsha zokwelashwa zokuphatha i-RA.

Ukuze ufunde kabanzi ngezindlela zakamuva zokwelashwa ze-RA, khuluma nodokotela wakho. Bangakusiza uqonde izinzuzo nezingozi ezingaba khona zokulungisa uhlelo lwakho lokwelashwa.Bangancoma nezinguquko zokuphila, njengokungabhemi noma ukuqhuma, ukukusiza ukuthi ujabulele impilo engcono kakhulu nekhwalithi yempilo enalesi simo.