Koj puas muaj tej lub sij hawm sawv ntxov uas koj xav tias koj lub cev nruj thiab tsis khov? Puas nyuaj rau khoov ib pliag? Qhov no yuav yog vim Ankylosing Spondylitis , ib yam mob uas cuam tshuam rau cov pob qij txha ntawm tus txha nraub qaum. Yog tias koj tau sim cov tshuaj tua kab mob uas yuav tsis tas yuav muaj daim ntawv yuav tshuaj ( NSAIDs ) thiab qhov mob thiab o tsis tau ploj mus, koj tus kws kho mob yuav pom zoo kom siv DMARD. Yog li cia peb mus rau hauv qab ntawm qhov no.
DMARDs yog dab tsi thiab lawv ua haujlwm li cas?
Hauv Ankylosing Spondylitis, peb lub cev tiv thaiv kab mob, lub cev tiv thaiv kab mob , ua haujlwm ntau dhau thiab pib tawm tsam peb cov pob qij txha caj qaum. Qhov no ua rau o , mob, thiab tawv uas ua rau nws nyuaj rau txav cov pob txha caj qaum kom raug.
DMARD yog ib lo lus luv rau 'Disease-Modifying Antirheumatic Drug' . Yog hais yooj yim xwb, nws txhais tau tias 'tshuaj kho mob pob qij txha uas hloov kab mob'. Cov tshuaj no ua haujlwm los ntawm kev ua kom lub cev tiv thaiv kab mob tsis ua haujlwm zoo. Tsis zoo li cov tshuaj tua kab mob ib txwm muaj (NSAIDs), cov tshuaj no tsis tsuas yog txo qhov mob xwb, tab sis kuj pab tswj kev loj hlob ntawm tus kab mob thiab tiv thaiv kev puas tsuaj ntxiv rau cov pob qij txha. Yog vim li ntawd lawv thiaj hu ua "tshuaj kho mob hloov kab mob".
Cov tshuaj DMARDs twg yog cov uas tau muab rau Ankylosing Spondylitis?
Cov tshuaj DMARD uas tau muab rau tus kab mob no muaj ntau hom loj. Lawv hu ua cov tshuaj biologics thiab cov tshuaj DMARD ib txwm muaj. Cia peb los saib txhua hom no.
| Hom tshuaj | Ib qho lus piav qhia luv luv |
|---|---|
| Cov khoom siv tshuaj lom neeg (piv txwv li cov tshuaj TNF inhibitors, IL-17 inhibitors) | Lawv ua haujlwm los ntawm kev tsom mus rau cov protein tshwj xeeb uas ua rau muaj kev o ntawm lub cev tiv thaiv kab mob. Cov no yog muab los ntawm kev txhaj tshuaj lossis kev txhaj tshuaj rau hauv cov hlab ntsha. |
| Cov tshuaj JAK inhibitors | Qhov no kuj yog ib hom DMARD tshiab. Cov no tsis yog cov tshuaj lom neeg. Lawv ua haujlwm los ntawm kev tsom mus rau ib pawg ntawm cov enzymes uas ua rau mob. Lawv tuaj yeem noj ua cov tshuaj ntsiav. |
| Cov tshuaj DMARD ib txwm muaj (piv txwv li Methotrexate, Sulfasalazine) | Cov no feem ntau yog siv rau mob pob qij txha ntawm cov pob qij txha sab nraud, xws li tes, taw, lub duav, thiab lub hauv caug. Lawv tsis tshua muaj txiaj ntsig zoo rau mob pob qij txha ntawm tus txha nraub qaum. |
Cov Tshuaj Biologics: Cov tshuaj uas ua haujlwm rau tib lub hom phiaj
Cov tshuaj lom neeg zoo li cov neeg tua phom tua neeg. Lawv tsuas yog tsom thiab tawm tsam cov protein uas ua rau muaj teeb meem xwb.
- Cov tshuaj TNF inhibitors: Cov no yog thawj pawg tshuaj biologic uas tau pom zoo rau ankylosing spondylitis. Lawv ua haujlwm los ntawm kev thaiv cov protein hu ua Tumor Necrosis Factor (TNF), uas ua rau mob o. Lawv tuaj yeem pab nrog mob pob qij txha ntawm tus txha nraub qaum thiab lwm cov pob qij txha, nrog rau cov mob uas tuaj yeem tshwm sim nrog tus kab mob, xws li uveitis , mob qhov muag, thiab Inflammatory Bowel Disease (IBD) ( Crohn's disease thiab ulcerative colitis). Koj tus kws kho mob feem ntau yuav sau cov no yog tias koj tau sim tsawg kawg yog ob hom tshuaj loog mob (NSAIDs) thiab tsis tau muaj txiaj ntsig dab tsi.
- Adalimumab (Humira)
- Certolizumab (Cimzia)
- Etanercept (Enbrel)
- Infliximab (Remicade)
- Golimumab (Simponi)
Xav txog seb, ib yam tshuaj TNF inhibitor tsis ua haujlwm rau koj. Tsis txhob txhawj. Tus kws kho mob tuaj yeem hloov koj mus rau lwm yam tshuaj hauv tib pawg. Ces muaj feem ntau uas koj yuav tau txais txiaj ntsig.
- IL-17 inhibitors: Cov no ua haujlwm los ntawm kev thaiv lwm cov protein uas ua rau mob hu ua Interleukin-17 (IL-17). Lawv yog ib qho kev xaiv zoo rau cov neeg uas tsis tau teb rau TNF inhibitors lossis cov neeg uas tsis tuaj yeem noj TNF inhibitors vim muaj mob xws li kab mob plawv lossis multiple sclerosis (MS).
- Ixekizumab (Taltz)
- Secukinumab (Cosentyx)
JAK inhibitors: Cov tshuaj tshiab uas tuaj yeem noj ua tshuaj ntsiav
Cov no txawv ntawm cov tshuaj biologics. Lawv yog ib qho kev daws teeb meem zoo rau ib tus neeg uas tsis nyiam txhaj tshuaj, vim lawv tuaj ua cov tshuaj ntsiav. Lawv ua haujlwm los ntawm kev tsom mus rau lub cev enzyme hu ua Janus Kinase (JAK), uas ua rau mob o.
- Tofacitinib (Xeljanz)
- Upadacitinib (Rinvoq)
DMARDs Ib Txwm Muaj: Cov tshuaj siv feem ntau rau cov pob qij txha peripheral
Cov no feem ntau yog muab rau qhov mob thiab o ntawm cov pob qij txha xws li tes, taw, lub duav, thiab lub hauv caug, es tsis yog qhov mob hauv tus txha nraub qaum.
- Tshuaj Methotrexate: Qhov no los ua tshuaj ntsiav lossis tshuaj txhaj. Nws pab tiv thaiv kev puas tsuaj rau cov pob qij txha.
- Sulfasalazine (Azulfidine): Qhov no kuj yog kev kho mob rau cov pob qij txha thiab IBD. Nws yog noj ua tshuaj ntsiav.
Tus kws kho mob yuav xaiv DMARD li cas rau koj?
Koj tus kws kho mob xav txog ntau yam thaum xaiv tshuaj.
- Koj cov tsos mob hnyav npaum li cas.
- Cov tshuaj uas koj tau siv yav dhau los thiab cov txiaj ntsig uas koj tau txais los ntawm lawv.
- Cov kev mob tshwm sim ntawm cov tshuaj no thiab lawv cuam tshuam li cas rau koj txoj kev noj qab haus huv.
Cov tshuaj no muaj tej yam tshwm sim li cas?
Ib yam li txhua yam tshuaj, DMARDs muaj peev xwm muaj cov kev mob tshwm sim. Qee qhov yog me me, thaum lwm tus tuaj yeem ua rau mob hnyav. Yog li ntawd, nrog koj tus kws kho mob tham txog cov no ua ntej pib noj tshuaj.
- Cov tshuaj Biologics thiab JAK inhibitors: Cov no ua rau lub cev tiv thaiv kab mob qeeb, ua rau nws tsis muaj peev xwm tiv thaiv kab mob. Yog li ntawd, nws yog ib qho tseem ceeb kom paub tseeb tias koj tau txhaj tshuaj tiv thaiv kab mob tas li ua ntej pib siv cov tshuaj no.
- Kev Kuaj Mob Ntsws (TB): Nws yog ib qho tseem ceeb uas yuav tsum tau kuaj mob ntsws ntsws (TB) ua ntej pib siv cov tshuaj TNF inhibitors, vim tias cov tshuaj no tuaj yeem ua rau cov kab mob ntsws ntsws uas tsis muaj zog hauv koj lub cev rov ua haujlwm dua.
- Lwm cov kev mob tshwm sim: Tej zaum yuav muaj qhov liab ntawm qhov chaw txhaj tshuaj, mob taub hau, thiab tawv nqaij ua pob. Cov tshuaj IL-17 inhibitors tej zaum yuav ua rau IBD mob hnyav dua.
Cov kev mob tshwm sim ntawm cov tshuaj DMARDs ib txwm muaj
- Methotrexate: Mob plab, mob qhov ncauj, thiab cov qe ntshav qis tuaj yeem ua rau muaj kev kis kab mob, kub taub hau, thiab mob nqaij. Yuav kom txo tau cov no, koj tus kws kho mob yuav muab cov tshuaj folic acid rau koj. Thaum noj cov tshuaj no , koj yuav tsum tau kuaj ntshav txhua 1-3 lub hlis los xyuas koj lub raum thiab daim siab ua haujlwm. Cov tshuaj no tsis pom zoo thaum cev xeeb tub.
- Sulfasalazine: Tej zaum yuav xeev siab, ntuav, ua xua rau tshav ntuj, tawv nqaij ua pob khaus, thiab mob taub hau. Cov tshuaj no yuav ua rau koj cov zis, hws, thiab kua muag hloov mus ua xim daj-txiv kab ntxwv. Nws tsis txaus ntshai, tab sis nws tuaj yeem ua rau cov khaub ncaws puas.
Qhov tseem ceeb tshaj plaws yog tsis txhob ntshai yog tias koj muaj tej yam tshwm sim tsis zoo thiab qhia rau koj tus kws kho mob tam sim ntawd.
Yuav tsum tau tos li cas thaum pib kho mob?
Cov tshuaj no tsis ua haujlwm zoo ib yam rau txhua tus. Tau txais cov txiaj ntsigNws yuav siv sijhawm ob peb lub lis piam lossis ib hlis lossis ob hlis. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum ua siab ntev. Tsis txhob cia li tsum tsis txhob noj tshuaj vim koj xav tias nws yuav tsis zoo dua.
Tsis tas li ntawd xwb, txawm tias koj cov tsos mob tau ploj mus tag lawm los xij, nws tseem ceeb heev rau koj kom txuas ntxiv noj koj cov tshuaj mus ntev li koj tus kws kho mob hais kom koj ua. Yog tias koj tsum tsis noj, tus kab mob yuav rov qab los dua.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Cov tshuaj DMARDs tsis zoo li cov tshuaj tua kab mob ib txwm muaj. Ntxiv rau qhov txo qhov mob, lawv kuj tswj kev loj hlob ntawm tus kab mob thiab tiv thaiv kev puas tsuaj rau cov pob qij txha.
- Muaj ntau hom tshuaj sib txawv, xws li cov tshuaj biologics, JAK inhibitors, thiab cov tshuaj DMARDs ib txwm muaj. Koj tus kws kho mob yuav xaiv cov tshuaj uas zoo tshaj plaws rau koj tus mob.
- Vim tias cov tshuaj no ua rau lub cev tiv thaiv kab mob tsis muaj zog, yog li ntawd yuav muaj kev pheej hmoo ntawm kev kis kab mob. Yuav tsum tau kuaj mob ntsws (TB) ua ntej pib siv cov tshuaj TNF inhibitors.
- Yuav siv sijhawm ntev thiaj pom cov txiaj ntsig, yog li ua siab ntev rau koj txoj kev kho mob. Txawm tias koj cov tsos mob ploj mus lawm los xij, tsis txhob tsum noj tshuaj yam tsis tau koj tus kws kho mob qhia.
- Yog tias koj muaj tej yam kev mob tshwm sim los yog muaj teeb meem dab tsi, nrog koj tus kws kho mob tham tam sim ntawd.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus