Momma yensua DMARDs, nnuru a wɔde sa Ankylosing Spondylitis no ho ade kɛkɛ.

So ɛtɔ mmere bi a wosɔre anɔpa a wote nka sɛ wo ho yɛ den na wo ho yɛ den? So ɛyɛ den sɛ wobɛkotow kakra? Eyi betumi afi Ankylosing Spondylitis , tebea bi a ɛka akyi berɛmo no nkwaa. Sɛ woasɔ nnuru a wɔde kum ɛyaw a wɔtɔn ( NSAIDs ) ahwɛ na ɛyaw ne ɔfe no ano ntew a, ebia wo duruyɛfo bɛkamfo DMARD akyerɛ wo. Enti momma yɛnkɔ eyi ase.

Dɛn ne DMARDs na ɛyɛ adwuma dɛn?

Wɔ Ankylosing Spondylitis mu no, yɛn nipadua no ahobammɔ nhyehyɛe, nipadua no mu tumi a ɛko tia nyarewa , yɛ adwuma boro so na efi ase tow hyɛ yɛn ankasa akyi berɛmo mu nkwaa so. Eyi ma ɔfe , ɛyaw, na ɛyɛ den ma ɛyɛ den sɛ wobɛkanyan akyi berɛmo no yiye.

DMARD yɛ ‘Aduru a Ɛsakra Yare’ a wɔatwa no tiaa’ . Sɛ yɛbɛka no tiawa a, ɛkyerɛ ‘ntini mu yare aduru a ɛsakra yare’. Saa nnuru yi yɛ adwuma denam nipadua no mu tumi a ɛko tia nyarewa a ɛyɛ adwuma boro so no a ɛma ɛyɛ komm so. Nea ɛnte sɛ nnuru a wɔde kum ɛyaw a wɔde di dwuma daa (NSAID) no, ɛnyɛ sɛ eyinom brɛ ɛyaw ase nko, na mmom ɛboa ma yare no kɔ so na esiw nkwaa no a ɛsɛe bio no ano nso. Ɛno nti na wɔfrɛ wɔn "yare-sesa" nnuru.

DMARD ahorow bɛn na wɔde ma wɔ Ankylosing Spondylitis ho?

Wobetumi akyekyɛ DMARD ahorow a wɔde ma ma yare yi mu akuw atitiriw pii. Wɔfrɛ wɔn biologics ne amammerɛ kwan so DMARDs. Momma yɛnhwɛ saa ahorow yi mu biara.

Biologics: Nnuru a ɛyɛ adwuma wɔ botae koro so

Biologics te sɛ atuo a wɔde tow tuo. Wɔde wɔn ani si protein ahorow a ɛde ɔhaw no ba tẽẽ nkutoo so na wɔtow hyɛ so.

• TNF inhibitors: Eyinom ne nnuru a edi kan a wɔde abɔde a nkwa wom yɛ a wɔapene so sɛ wɔmfa nyɛ ankylosing spondylitis. Wɔnam protein bi a wɔfrɛ no Tumor Necrosis Factor (TNF) a ɛde ɔfe ba a wosiw ano so na ɛyɛ adwuma. Wobetumi aboa wɔ akyi berɛmo ne nkwaa afoforo mu ntini mu yare, ne tebea horow a ebetumi aba wɔ yare no ho, te sɛ uveitis , aniwa a ɛyɛ hyew, ne Inflammatory Bowel Disease (IBD) ( Crohn’s disease and ulcerative colitis). Mpɛn pii no, wo duruyɛfo bɛkyerɛw eyinom ama wo sɛ anyɛ yiye koraa no, sɛ woasɔ nnuru ahorow abien a wɔde kum ɛyaw (NSAID) ahwɛ na ennyaa nkɛntɛnso biara a.
• Adalimumab (Humira) a wɔde di dwuma wɔ ɔkwan a ɛyɛ nwonwa so.
• Nnuru a wɔfrɛ no Certolizumab (Cimzia) .
• Etanercept (Enbrel) 1. Ɔde ne nsa kyerɛɛ ne so.
• Infliximab (Nneɛma a wɔde sa yare) .
• Golimumab (Simponi) a wɔde di dwuma wɔ ɔkwan a ɛyɛ nwonwa so.

• Nnuru a esiw IL-17 ano: Eyinom yɛ adwuma denam protein foforo a ɛma ɔhyew a wɔfrɛ no Interleukin-17 (IL-17) a wosiw ano no so. Wɔyɛ ɔkwan pa a nnipa a wɔnyɛ wɔn ade wɔ nnuru a esiw TNF ano ho anaasɛ wontumi nnom nnuru a esiw TNF ano esiane tebea horow te sɛ komayare anaa multiple sclerosis (MS) nti.
• Ixekizumab (Taltz) a wɔde yɛ aduru a wɔfrɛ no Ixekizumab .
• Secukinumab (Aduru a wɔfrɛ no Cosentyx) .

JAK inhibitors: Nnuru foforo a wobetumi anom sɛ nnuru a wɔde siw yare ano

Eyinom yɛ soronko wɔ biologics ho. Wɔyɛ ano aduru pa ma obi a n’ani nnye injections ho, efisɛ ɛba wɔ pill kwan so. Wɔnam enzyme nhyehyɛe bi a wɔfrɛ no Janus Kinase (JAK) a ɛde ɔfe ba a wɔde wɔn ani si so so na ɛyɛ adwuma.

• Tofacitinib (Xeljanz) a wɔde ma .
• Upadacitinib (Rinvoq) .

DMARD ahorow a wɔde di dwuma wɔ amanne kwan so: Nnuru a wɔtaa de yɛ nkwaa a ɛwɔ akyi no

Wɔde eyinom ma titiriw ma ɛyaw ne nkwaa a ɛho ahonhon te sɛ nsa, anan, asen, ne nkotodwe, sen sɛ ɛbɛyɛ yaw wɔ akyi berɛmo mu.

• Methotrexate: Eyi ba sɛ aduru anaa aduru a wɔde twitwiw nipadua no mu. Ɛboa ma nkwaa no nsɛe.
• Sulfasalazine (Azulfidine): Eyi nso yɛ aduru a wɔde sa nkwaa a ɛwɔ akyi ne IBD. Wɔnom sɛ aduru a wɔde sa yare.

Ɔkwan bɛn so na oduruyɛfo paw DMARD a ɛfata ma wo?

Wo duruyɛfo susuw nneɛma pii ho bere a worepaw aduru bi no.

• Hwɛ sɛnea wo sɛnkyerɛnne ahorow no mu yɛ den.
• Nnuru a wode adi dwuma bere bi a atwam ne nea afi mu aba a woanya afi mu.
• Nsunsuanso bɔne a ɛwɔ aduru a yɛreka ho asɛm no mu ne sɛnea ɛka w’akwahosan.

Dɛn ne aduru yi mu nsunsuanso bɔne?

Te sɛ nnuru nyinaa no, DMARD ahorow betumi anya nsunsuanso bɔne. Ebi yɛ nketewa, bere a afoforo nso betumi ayɛ aniberesɛm. Enti wo ne wo duruyɛfo nka eyinom ho asɛm ansa na woafi aduru no ase.

• Biologics ne JAK inhibitors: Eyinom ma nipadua no mu tumi a ɛko tia nyarewa no brɛ ase, na ɛma entumi ko tia nyarewa. Enti, ɛho hia sɛ wohwɛ hu sɛ wobɛhu wo nnuru a wɔde bɔ wo ho ban nyinaa ansa na woafi nnuru yi ase.
• Nsanyare (TB) Sɔhwɛ: Ɛho hia sɛ wosɔ nsamanwaw (TB) hwɛ ansa na woafi nnuru a esiw TNF ano ase, efisɛ saa nnuru yi betumi ama TB mmoawa a wɔada wɔ wo nipadua mu no asan ayɛ adwuma.
• Nneɛma afoforo a ɛde ba: Ebetumi ayɛ kɔkɔɔ wɔ baabi a wɔde aduru no ahyɛ no, tiyɛ, ne honam ani akisikuru betumi aba. Ɛtɔ mmere bi a, nnuru a esiw IL-17 ano betumi ama IBD asɛe kɛse.

Nneɛma bɔne a efi DMARD ahorow a wɔde di dwuma wɔ amanne kwan so mu ba

• Methotrexate: Yafunu a ɛyɛ yaw, ano a ɛyɛ kuru, ne mogya mu nkwammoaa a ɛba fam betumi ama obi anya ɔyare mmoawa, atiridiinini, ne akuru. Nea ɛbɛyɛ na eyinom so atew no, wo duruyɛfo bɛma wo folic acid aduru. While taking this medication , ɛho behia sɛ woyɛ mogya mu nhwehwɛmu asram 1-3 biara de hwɛ sɛnea w’asaabo ne wo mmerɛbo yɛ adwuma. Wɔnkamfo saa aduru yi nkyerɛ bere a wɔyem.
• Sulfasalazine: Ebia akisikuru, ɔfe, owia hann a ɛyɛ mmerɛw, honam ani akisikuru, ne tiyɛ betumi aba. Saa aduru yi betumi adan wo nsu, wo fifiri, ne wo nusu ayɛ kɔla kɔkɔɔ-akutu. Ɛnyɛ nea asiane wom, nanso ebetumi agu ntade so.

Dɛn na ɛsɛ sɛ yɛhwɛ kwan bere a worefi ayaresa ase no?

Saa nnuru yi nyɛ adwuma pɛpɛɛpɛ mma obiara. Nya nea efi mu baEbetumi agye adapɛn kakraa bi anaa ɔsram biako anaa abien. Enti ɛho hia sɛ yenya abotare. Nnyae aduru no nom mpofirim esiane sɛ wususuw sɛ ɛrenyɛ yiye nti.

Afei nso, sɛ wo yare no ho sɛnkyerɛnne no ano abrɛ ase koraa mpo a, ɛho hia paa sɛ wobɛkɔ so nom w’aduru no bere tenten a wo duruyɛfo ka kyerɛ wo no. Sɛ wugyae a, ebia yare no bɛsan asɔ bio.