Romiplostim ikora neza kuruta ubuvuzi busanzwe bwa immun trombocytopenia
Romiplostim ikora neza kuruta ubuvuzi busanzwe bwa immun trombocytopenia
Anonim

Ubushakashatsi bushya bwagaragaje ko imiti yemewe na FDA yo kuvura indwara idasanzwe ya autoimmune immunite tromobocytopenia (ITP) ikora neza kuruta ubuvuzi bwa mbere bwo gufasha abarwayi kwirinda kwivuza no kuzamura imibereho yabo. Uru rupapuro rwasohotse mu kinyamakuru New England Journal of Medicine cyo ku ya 11 Ugushyingo ruvuga ko kuvura hamwe na romiplostim, bigana ingaruka ziterwa no gukura bigenga umusaruro wa platine, byatsinze inshuro zirenga eshatu kuruta ubuvuzi busanzwe hamwe na steroid cyangwa imiti ikingira indwara.

David Kuter, MD, DPhil, wo mu bitaro bikuru bya kanseri bya Massachusetts (MGH), ayobora akaba n'umwanditsi, agira ati: "Ubu ni bwo bushakashatsi bwa mbere busobanutse kuri ubu bwoko bw'imiti bwerekana ko abarwayi bagize iterambere ry’amavuriro, atari ukongera urugero rwa platine." y'ubushakashatsi. "Ryemeza ko kuvura bigira icyo bihindura ku barwayi uretse kunoza umubare wa platine."

Muri ITP, yibasira umuntu umwe kuri 10 000 000, sisitemu yumubiri itanga antibodies zirwanya platine, selile yamaraso ningirakamaro kugirango habeho. Amashanyarazi yibasiwe no kurimbuka, agashyira abarwayi mu kaga. Mugihe ikibazo cyabana gikunze gukemuka mumezi 6, muri bitatu bya kane byabantu bakuze bibaye karande. Kugirango wirinde kuva amaraso akomeye, abarwayi barashobora kugabanya cyane imibereho yabo, bakirinda imyitozo ngororamubiri hamwe nubuvuzi nka colonoskopi no gukuramo amenyo.

Ubuvuzi bwa ITP bumaze igihe kinini bushingiye kuri steroid cyangwa imiti ikingira indwara, bigira ingaruka zikomeye abarwayi benshi basanga batihanganirwa. Abarwayi benshi amaherezo bakuramo intanga zabo, zishobora kuzamura urwego rwa platel kugeza kumyaka itanu; ariko kubarwayi bakuze cyangwa abafite ibibazo byubuvuzi, splenectomy ntishobora kuba umutekano cyangwa ubuvuzi. Igeragezwa ry’amavuriro ya romiplostim, rimwe mu itsinda rishya ry’ibiyobyabwenge ryigana ingaruka ziterwa no gukura kwa trombopoietin, ryerekanye ko ryongereye umubare wa platine y’abarwayi ba ITP kugeza ku myaka itanu, ariko ubwo bushakashatsi ntabwo bwagereranije ingaruka zabwo n’ubuvuzi busanzwe. ntanubwo wasuzumye ivuriro rifite urwego rwo hejuru.

Ubu bushakashatsi - bwatewe inkunga na Amgen, bugurisha romiplostim ku izina rya Nplate - bwanditse abarwayi 234 bakuze ba ITP ku mbuga 85 zo muri Amerika y'Amajyaruguru, Uburayi na Ositaraliya. Abitabiriye amahugurwa, nta n'umwe muri bo wigeze akuramo intanga, bahawe ku bushake imiti isanzwe yita ku baganga bavura cyangwa inshinge za romiplostim buri cyumweru. Abitabiriye ayo matsinda yombi bashoboye kwakira ubundi buvuzi bwabaye ngombwa. Ubuvuzi bwafatwaga nkubusa niba urwego rwa platine rwakomeje kuba ruto mugihe cibyumweru bine bikurikiranye cyangwa niba abitabiriye bahuye nibibazo bikomeye byo kuva amaraso cyangwa impinduka zikenewe mubuvuzi, harimo na splenectomy.

Nyuma yicyumweru 52 cyo kwiga, abitabiriye kwakira romiplostim bagezeho kandi bakomeza urwego rwa platel rwikubye inshuro zirenga ebyiri igipimo cyabafite ubuvuzi busanzwe. Muri rusange, kuvura romiplostim byibuze byibuze inshuro eshatu nkubundi buvuzi, kandi abitabiriye kwakira imiti bagabanutseho 90% mugukenera splenectomy. Ibisubizo kubikoresho byinshi byubuzima-byubuzima byari hejuru cyane kubitabiriye kwakira romiplostim.

Kuter agira ati: "Twari twizeye ko iyi miti izagira akamaro kuruta ubuvuzi, ariko twatangajwe n'ukuntu yagize akamaro". Avuga ko ibibazo byinshi bigikenewe gukemurwa mbere y’ahantu romiplostim ivura igihe kirekire ivura ITP. Imwe murimwe nigikorwa cyo kuvura neza, kuko gihenze; ikindi ni ukumenya niba abarwayi bakira romiplostim bashobora gukomeza kwirinda splenectomy igihe kirenze umwaka. Ubushakashatsi bwiyongereye kandi bugomba kumenya niba kuvura romiplostim bishobora gukomeza ubuziraherezo.

"Ubushakashatsi bwacu bwanditse ku barwayi mu byiciro bitandukanye by’indwara zabo - bamwe bari baherutse gupimwa, abandi bakaba baravuwe imyaka myinshi. Ubushakashatsi bw'ejo hazaza bugomba kureba niba romiplostim ishobora kuba imiti iboneye ku barwayi baherutse gupimwa, kubafasha kwirinda burundu gufata steroyide, "ibi bikaba byavuzwe na Kuter, umuyobozi w'ikigo gishinzwe kuvura indwara zo mu kigo cya kanseri ya MGH akaba n'umwarimu w’ubuvuzi mu ishuri ry’ubuvuzi rya Harvard.

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