Yuav Kho Cov Qhov Ncauj Rau MS Li Cas?

Zoo Siab

• Txoj haujlwm ntawm B cell thiab T cell
• Cladribine (Mavenclad)
• Dimethyl fumarate (Tecfidera)
• Diroximel fumarate (Vumerity)
• Ntiv tes (Gilenya)
• Siponimod (Mayzent)
• Teriflunomide (Aubagio)
• Lwm yam tshuaj-siv tshuaj kho kab mob
• Muaj feem pheej hmoo tshwm sim los ntawm DMTs
• Tswj cov kev pheej hmoo ntawm kev phiv
• Cov nqa mus
• Nov yog Dab Tsi nws Xav Nyob Nrog MS

Ntau yam sclerosis (MS) yog ib qho kev tiv thaiv kabmob uas tiv thaiv koj lub cev tiv thaiv cov txheej txheem tiv thaiv ib puag ncig cov hlab ntsha hauv koj cov hlab ntsha hauv nruab nrab (CNS). CNS suav nrog koj lub hlwb thiab tus txha caj qaum.

Cov kev kho kom hloov cov kab mob (DMTs) yog cov kev pom zoo uas siv tau los pab txo kev txhim kho MS. DMTs tuaj yeem pab ncua kev tsis taus thiab txo cov nplaim hluav taws hauv cov neeg muaj tus mob.

Lub Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA) tau pom zoo ntau yam DMTs los kho kho cov ntawv rov ua haujlwm ntawm MS, suav nrog rau rau 6 DMT uas tau noj qhov ncauj ua tshuaj ntsiav lossis ntsiav tshuaj.

Nyeem rau kom paub ntau ntxiv txog DMT qhov ncauj thiab seb lawv ua haujlwm li cas.

Txoj haujlwm ntawm B cell thiab T cell

Txhawm rau kom nkag siab li cas qhov ncauj DMTS pab kho MS, koj yuav tsum paub txog lub luag haujlwm ntawm qee cov qog ua haujlwm hauv MS.

Ntau hom kev tiv thaiv kabmob hlwb thiab cov lwg me me tau koom nrog qhov tsis muaj zog tiv thaiv lub cev tsis txaus uas ua rau tus mob o thiab puas tsuaj hauv MS.

Cov no suav nrog T cell thiab B cell, ob hom qe ntshav dawb hu ua lymphocytes. Lawv tau tsim tawm hauv koj lub cev kev ua kom lymphatic.

Thaum T cell txav los ntawm koj cov lymphatic system mus rau hauv koj cov hlab ntshav, lawv tuaj yeem taug kev mus rau koj CNS.

Qee hom T cell tsim cov protein hu ua cytokines, uas ua rau mob o. Hauv cov neeg uas muaj MS, cytokines pro-inflammatory ua rau cov myelin thiab cov hlab ntsha puas tsuaj.

Cov cell B kuj tseem ua cov cytokines pro-inflammatory, uas tuaj yeem pab tsav cov kev ua ub ua no ntawm cov kab mob T hauv MS. Cov cell B kuj tseem ua cov tshuaj tiv thaiv, uas tuaj yeem ua lub luag haujlwm hauv MS.

Ntau DMT ua haujlwm los ntawm kev txwv cov kev ua kom ciaj sia, lossis kev txav mus los ntawm T cell, B cell, lossis ob qho tib si. Qhov no pab txo kev o thiab ua puas hauv CNS. Qee yam DMTs tiv thaiv cov qe ntshav ntawm kev puas tsuaj los ntawm lwm txoj kev.

Cladribine (Mavenclad)

FDA tau pom zoo siv cov cladribine (Mavenclad) los kho kho cov mob ntawm MS ntawm cov laus. Txog niaj hnub no, tsis muaj kev tshawb nrhiav tau ua tiav ntawm kev siv Mavenclad hauv menyuam yaus.

Thaum ib tug neeg noj cov tshuaj no, nws nkag rau hauv T cell thiab B cell hauv lawv lub cev thiab cuam tshuam nrog cov cell lub peev xwm los ua ke thiab kho DNA. Qhov no ua rau cov kab mob tuag, txo cov lej thiab cov qe ntshav hauv lawv lub cev tiv thaiv kab mob.

Yog tias koj tau txais kev kho mob nrog Mavenclad, koj yuav tsum kawm ob yam ntawm cov tshuaj ntau dua 2 xyoos. Txhua chav kawm yuav koom nrog 2 lub lim tiam kho, sib cais los ntawm 1 hlis.

Txhua lub lim tiam ntawm kev kho mob, koj tus kws kho mob yuav qhia koj kom noj ib lossis ob zaug tshuaj noj ib hnub rau 4 lossis 5 hnub.

Dimethyl fumarate (Tecfidera)

FDA tau pom zoo dimethyl fumarate (Tecfidera) rau kev kho mob rov ua mob MS ntawm cov neeg laus.

Lub FDA tsis tau pom zoo Tecfidera los kho MS rau menyuam yaus. Txawm li cas los xij, cov kws kho mob tuaj yeem sau ntawv rau cov tshuaj no rau cov menyuam yaus hauv kev xyaum ua "npe-ntawv cim".

Txawm hais tias yuav tsum muaj kev tshawb fawb ntxiv, kev kawm txog hnub no qhia tias cov tshuaj no muaj kev nyab xeeb thiab zoo rau kev kho MS rau menyuam yaus.

Cov kws tshaj lij tsis paub meej tias Tecfidera ua haujlwm li cas. Txawm li cas los xij, cov kws tshawb nrhiav tau pom cov tshuaj no yuav txo qis ntau yam muaj qee hom T cell thiab B cell, ntxiv rau cytokines tiv thaiv kab mob.

Tecfidera kuj tshwm sim rau cov protein ua lub zog hu ua nuclear factor erythroid 2-cuam tshuam ntsig txog (NRF2). Qhov no ua rau cov lus teb ntawm cev xov tooj uas pab tiv thaiv cov hlab ntshav ntawm kev ntxhov siab oxidative.

Yog tias koj tau raug xaj los ntawm Tecfidera, koj tus kws kho mob yuav qhia koj kom noj ob 120-milligram (mg) ib hnub rau thawj 7 hnub ntawm kev kho mob. Tom qab thawj lub lim tiam, lawv yuav qhia koj kom noj ob koob tshuaj 240-mg ib hnub nyob rau ib hnub.

Diroximel fumarate (Vumerity)

FDA tau pom zoo rau diroximel fumarate (Vumerity) los kho cov mob huam ntawm MS hauv cov neeg laus. Cov kws paub tseem tsis tau paub meej tias qhov tshuaj no puas nyab xeeb lossis muaj txiaj ntsig zoo rau menyuam yaus.

Vumerity yog ib feem ntawm tib chav kawm tshuaj zoo li Tecfidera. Zoo li Tecfidera, nws ntseeg tau tias ua kom muaj protein ntau NRF2. Qhov no teev tawm cov lus teb ntawm tes uas pab tiv thaiv kev puas tsuaj rau cov leeg hlwb.

Yog tias koj txoj kev npaj kho mob suav nrog Vumerity, koj tus kws kho mob yuav qhia koj kom noj 231 mg ntawm cov tshuaj ob zaug ib hnub rau thawj 7 hnub. Txij thaum ntawd, koj yuav tsum tom qab ntawd noj 462 mg tshuaj ib hnub ob zaug.

Ntiv tes (Gilenya)

FDA tau pom zoo rau cov ntsis ntiv tes (Gilenya) rau kev kho mob rov ua mob MS ntawm cov neeg laus thiab cov menyuam hnub nyoog 10 xyoo lossis tshaj saud.

FDA tseem tsis tau pom zoo cov tshuaj no rau kev kho cov menyuam yau, tab sis cov kws kho mob yuav muab tshuaj rau cov menyuam tsis tau muaj 10 xyoo.

Cov tshuaj no txhais ib hom kev taw qhia txog molecule hu ua sphingosine 1-phosphate (S1P) los ntawm khi rau T cell thiab B cell. Nyeg, qhov no tiv thaiv cov hlwb ntawm nkag mus rau cov hlab ntshav thiab mus ncig ntawm CNS.

Thaum cov hlwb ntawd nres ntawm kev mus ncig rau CNS, lawv tsis tuaj yeem ua rau o thiab ua rau puas tsuaj nyob ntawd.

Gilenya noj ib hnub ib zaug. Hauv cov neeg uas hnyav dua li 88 phaus (40 phaus), qhov kev xav kom noj txhua hnub yog 0.5 mg. Hauv cov neeg uas hnyav dua li qhov hnyav, qhov xav kom noj nyob rau txhua hnub yog 0.25 mg.

Yog tias koj pib kho mob nrog cov tshuaj no thiab tom qab ntawd tsum tsis siv nws, koj tuaj yeem pom kev kub nyhiab loj.

Qee tus neeg nrog MS tau tsim kev loj hlob hauv qhov muaj mob xiam oob qhab thiab mob hlwb tshiab ntxiv tom qab lawv tsum tsis noj cov tshuaj no.

Siponimod (Mayzent)

FDA tau pom zoo siponimod (Mayzent) rau kev kho mob rov ua mob MS ntawm cov neeg laus. Txog tam sim no, cov kws tshawb nrhiav tseem tsis tau ua tiav ib txoj kev tshawb fawb txog kev siv cov tshuaj no rau menyuam yaus.

Mayzent yog nyob hauv tib chav tshuaj zoo ib yam li Gilenya. Zoo li Gilenya, nws thaiv S1P los ntawm khi rau T cell thiab B cell. Qhov no txwv cov hlwb tiv thaiv kab mob los ntawm kev taug kev mus rau lub hlwb thiab tus txha caj qaum, qhov uas lawv tuaj yeem tsim kev puas tsuaj.

Mayzent noj ib zaug ib hnub. Txhawm rau txiav txim siab koj cov tshuaj noj zoo txhua hnub, koj tus kws kho mob yuav pib los ntawm kev soj ntsuam koj rau cov cim caj ces uas tuaj yeem pab kwv yees koj cov lus teb rau cov tshuaj no.

Nws kev tshuaj ntsuam koj lub caj ces qhia hais tias cov tshuaj no yuav ua haujlwm zoo rau koj, koj tus kws kho mob yuav sau ntawv tawm me me kom pib. Lawv yuav maj mam nce koj cov tshuaj rau hauv tus txheej txheem ntawm kev hu ua titration. Lub hom phiaj yog txhawm rau ua kom muaj txiaj ntsig zoo thaum uas txiav tawm cov kev mob tshwm sim.

Yog tias koj noj cov tshuaj no thiab tom qab ntawd tsum tsis siv nws, koj tus mob yuav mob hnyav dua.

Teriflunomide (Aubagio)

FDA tau pom zoo siv teriflunomide (Aubagio) rau kev kho mob rov ua mob ntawm MS hauv cov neeg laus. Tsis muaj kev tshawb fawb tau tshaj tawm txog qhov kev siv cov tshuaj no hauv menyuam yaus.

Aubagio thaiv cov enzyme hu ua dihydroorotate dehydrogenase (DHODH). Qhov enzyme no koom tes nrog kev tsim cov pyrimidine, ib lub tsev thaiv DNA uas xav tau rau DNA synthesis hauv T cell thiab B cell.

Thaum qhov enzyme no tsis tuaj yeem nkag mus rau pyrimidine txaus rau coj los ua ke DNA, nws txwv qhov tsim muaj cov T tshiab thiab B cell.

Yog tias koj tau txais kev kho mob nrog Aubagio, koj tus kws kho mob tuaj yeem sau tshuaj rau 7- lossis 14-mg koob tshuaj ib hnub.

Lwm yam tshuaj-siv tshuaj kho kab mob

Ntxiv rau cov tshuaj noj ntawm qhov ncauj, FDA tau pom zoo rau ntau cov tshuaj DMT uas tau txhaj rau hauv qab daim tawv nqaij lossis muab los ntawm kev tso ntshav ua paug.

Lawv suav nrog:

• alemtuzumab (Lemtrada)
• glatiramer acetate (Copaxone, Glatect)
• interferon beta-1 (Avonex)
• interferon beta-1a (Rebif)
• interferon beta-1b (Betaseron, Extavia)
• mitoxantrone (Novantrone)
• natalizumab (Tysabri)
• ocrelizumab (Ocrevus)
• peginterferon beta-1a (Plegridy)

Tham nrog koj tus kws kho mob kom paub ntau ntxiv txog cov tshuaj no.

Muaj feem pheej hmoo tshwm sim los ntawm DMTs

Kev kho nrog DMTs tuaj yeem ua rau muaj kev mob tshwm sim, uas qee qhov mob loj heev.

Cov kev mob tshwm sim los ntawm kev kho mob sib txawv raws li hom DMT uas koj noj.

Qee qhov kev mob tshwm sim muaj xws li:

• mob taub hau
• xeev siab
• ntuav
• zawv plab
• daim tawv nqaij ua pob
• plaub hau poob
• lub plawv dhia qeeb
• ntsej muag yaug
• tsam plab tsis xis nyob

DMTs tseem muaj kev txuas rau kev pheej hmoo kis tus mob, xws li:

• khaub thuas
• mob ntsws
• tuberculosis
• txhav xaj
• qee yam mob fungal
• nce qib multifocal leukoencephalopathy, ib hom mob hlwb tsawg

Txoj kev pheej hmoo kis tus mob tau zoo heev yog vim tias cov tshuaj no hloov koj lub cev tiv thaiv kab mob thiab yuav txo qis cov qe ntshav dawb nyob rau hauv koj lub cev.

DMTs yuav ua rau muaj kev phiv loj heev, xws li ua mob rau daim siab thiab ua rau muaj kev fab loj. Qee qhov DMT yuav ua rau koj cov ntshav siab nce siab. Qee qhov yuav ua rau koj lub plawv dhia qeeb.

Nco ntsoov tias koj tus kws kho mob yuav pom zoo DMT yog tias lawv ntseeg tias cov txiaj ntsig zoo yuav muaj ntau dua qhov txaus ntshai.

Ua neej nyob nrog MS uas tsis tau tswj hwm zoo kuj ua rau muaj kev pheej hmoo txaus ntshai. Tham nrog koj tus kws kho mob kom paub ntau ntxiv txog cov kev mob tshwm sim thiab cov txiaj ntsig zoo ntawm txawv DMTs.

DMT tsis feem ntau suav hais tias yog kev nyab xeeb rau cov neeg cev xeeb tub lossis pub niam mis.

Tswj cov kev pheej hmoo ntawm kev phiv

Ua ntej koj pib kho nrog DMT, koj tus kws kho mob yuav tsum kuaj koj tus kab mob nquag, mob siab, thiab lwm yam teebmeem kev noj qab haus huv uas tuaj yeem ua rau muaj kev pheej hmoo ntawm kev noj tshuaj.

Koj tus kws kho mob tseem tuaj yeem txhawb koj kom txhaj tshuaj tiv thaiv kab mob ua ntej koj pib kho nrog DMT. Koj yuav tsum tau tos ntev li ob peb lub lis piam tom qab tau txais kev txhaj tshuaj ua ntej koj pib noj cov tshuaj.

Lub sijhawm koj tseem tab tom tau txais kev kho mob nrog DMT, koj tus kws kho mob yuav qhia koj kom zam qee yam tshuaj, khoom noj khoom haus zoo, lossis lwm yam khoom. Nug lawv yog tias muaj cov tshuaj lossis lwm cov khoom lag luam uas tuaj yeem cuam tshuam lossis cuam tshuam nrog DMT.

Koj tus kws kho mob yuav tsum saib xyuas koj kom pom cov kev mob tshwm sim thaum thiab tom qab kho nrog DMT. Piv txwv li, lawv yuav tuaj yeem yuav kuaj ntshav tas li kom kuaj xyuas koj cov ntshav thiab lub qe ntshav ua haujlwm siab.

Yog koj xav tias koj tuaj yeem ntsib kev mob tshwm sim, qhia rau koj tus kws kho mob paub tam sim ntawd.

Cov nqa mus

Ntau DMTs tau txais kev pom zoo los kho MS, suav nrog rau 6 hom kev kho qhov ncauj.

Qee cov tshuaj yuav zoo dua lossis zoo rau qee tus neeg dua li lwm tus.

Ua ntej koj pib noj DMT, nug koj tus kws kho mob txog cov txiaj ntsig zoo thiab kev pheej hmoo ntawm kev siv nws. Lawv tuaj yeem pab koj nkag siab tias cov kev kho mob sib txawv yuav cuam tshuam li cas rau koj lub cev thiab kev xav tau ntev ntev nrog MS.

Nov yog Dab Tsi nws Xav Nyob Nrog MS