Ngaba ngamanye amaxesha uvuka kusasa uzive uqinile kwaye uqinile? Ngaba kunzima ukugoba okwethutyana? Oku kusenokuba kubangelwa yi -Ankylosing Spondylitis , imeko echaphazela amalungu omqolo. Ukuba ukhe wazama amayeza okunciphisa iintlungu ( NSAIDs ) ngaphandle kwemvume kagqirha kwaye iintlungu kunye nokudumba azikapheli, ugqirha wakho unokucebisa i-DMARD. Ngoko masifikelele ezantsi koku.
Zithini ii-DMARD kwaye zisebenza njani?
Kwi-Ankylosing Spondylitis, inkqubo yokuzikhusela yomzimba wethu, inkqubo yokuzikhusela, iyasebenza kakhulu ize iqale ukuhlasela amalungu ethu omqolo. Oku kubangela ukudumba , iintlungu, kunye nokuqina okwenza kube nzima ukuhambisa umqolo ngokufanelekileyo.
I-DMARD sisifinyezo segama elithi 'Iyeza Lokulwa Nezifo Elitshintsha Isifo' . Ngamafutshane, lithetha 'amayeza e-arthritis atshintsha isifo'. La mayeza asebenza ngokuthomalalisa inkqubo yomzimba yokuzikhusela esebenza kakhulu. Ngokungafaniyo nee-NSAIDs eziqhelekileyo, la mayeza awanciphisi nje kuphela iintlungu, kodwa anceda nokulawula ukuqhubela phambili kwesifo kwaye athintele umonakalo ongakumbi kumalungu. Yiyo loo nto ebizwa ngokuba ngamayeza "okuguqula izifo".
Ziziphi iintlobo ze-DMARD ezinikwayo kwi-Ankylosing Spondylitis?
Ii-DMARD ezinikwa esi sifo zinokwahlulwa zibe ziindidi eziphambili ezininzi. Zibizwa ngokuba zii-biologics kunye nee-DMARD zemveli. Makhe sijonge nganye kwezi ntlobo.
| Uhlobo lweziyobisi | Inkcazo emfutshane |
|---|---|
| I-Biologics (umz. izithinteli ze-TNF, izithinteli ze-IL-17) | Zisebenza ngokujolisa kwiiproteni ezithile ezibangela ukudumba kwinkqubo yomzimba yokuzikhusela. Ezi zinikwa ngenaliti okanye nge-intravenous infusion. |
| Izithinteli zeJAK | Olu lukwaluhlobo olutsha lwe-DMARD. Ezi azizozinto eziphilayo. Zisebenza ngokujolisa kwiqela lee-enzyme ezibangela ukudumba. Zingasetyenziswa njengeepilisi. |
| IiDMARD zemveli (umz. iMethotrexate, iSulfasalazine) | Ezi zisetyenziswa kakhulu kwi-arthritis yamalungu angaphandle, njengezandla, iinyawo, izinqe, namadolo. Azisebenzi kangako kwi-arthritis yomqolo. |
I-Biologics: Amayeza asebenza kwindawo enye
Iibhayoloji zifana nezibhamu ezidubulayo. Zijolise kwaye zihlasele kuphela iiproteni ezibangela ingxaki ngokuthe ngqo.
- Izithinteli ze-TNF: Ezi ziindidi zokuqala zamayeza ebhayoloji avunyiweyo kwi-ankylosing spondylitis. Zisebenza ngokuthintela iproteni ebizwa ngokuba yiTumor Necrosis Factor (TNF), ebangela ukudumba. Zinokunceda kwi-arthritis yomqolo kunye namanye amalungu, kunye neemeko ezinokwenzeka ngesifo, ezifana ne -uveitis , ukudumba kwamehlo, kunye ne -Inflammatory Bowel Disease (IBD) ( isifo sikaCrohn kunye ne-ulcerative colitis). Ugqirha wakho uya kunika ezi zinto ukuba uzame ubuncinane iintlobo ezimbini zeentlungu (ii-NSAID) kwaye awuzange ube nasiphumo.
- I-Adalimumab (iHumira)
- I-Certolizumab (iCimzia)
- I-Etanercept (Enbrel)
- I-Infliximab (iRemicade)
- IGolimumab (iSimponi)
Khawucinge nje, i-TNF inhibitor enye ayisebenzanga kuwe. Ungakhathazeki. Ugqirha angakutshintshela kwelinye iyeza elikudidi olufanayo. Emva koko kukho ithuba elihle lokuba ufumane iziphumo.
- Izithinteli ze-IL-17: Ezi zisebenza ngokuthintela enye iproteni yokuvuvukala ebizwa ngokuba yi-Interleukin-17 (IL-17). Ziyindlela elungileyo kubantu abangakhange baphendule kwizithinteli ze-TNF okanye abangakwaziyo ukuthatha izithinteli ze-TNF ngenxa yeemeko ezifana nesifo sentliziyo okanye i-multiple sclerosis (MS).
- Ixekizumab (Taltz)
- ISecukinumab (iCosentyx)
Izithinteli zeJAK: Amayeza amatsha anokuthatyathwa njengeepilisi
Ezi zahlukile kwi-biologics. Zisisisombululo esilungileyo kumntu ongathandiyo ukujova, kuba ziza zikwimo yeepilisi. Zisebenza ngokujolisa kwinkqubo ye-enzyme ebizwa ngokuba yiJanus Kinase (JAK), ebangela ukudumba.
- I-Tofacitinib (Xeljanz)
- I-Upadacitinib (Rinvoq)
IiDMARD zemveli: Amayeza asetyenziswa kakhulu kumalungu angaphandle
Ezi zinikwa ikakhulu ngenxa yentlungu nokudumba kwamalungu afana nezandla, iinyawo, izinqe, namadolo, endaweni yentlungu yomqolo.
- I-Methotrexate: Le iza njengepilisi okanye inaliti. Inceda ekuthinteleni umonakalo kumalungu.
- I-Sulfasalazine (i-Azulfidine): Le ikwayindlela yonyango lwamalungu angaphandle kunye ne-IBD. Ithathwa njengepilisi.
Ugqirha ukhetha njani i-DMARD efanelekileyo kuwe?
Ugqirha wakho uqwalasela izinto ezininzi xa ekhetha iyeza.
- Indlela ezibukhali ngayo iimpawu zakho.
- Amayeza owakhe wawasebenzisa ngaphambili kunye neziphumo ozifumeneyo kuwo.
- Iziphumo ebezingalindelekanga zeyeza elikhankanyiweyo kunye nendlela ezichaphazela ngayo impilo yakho.
Zithini iziphumo ebezingalindelekanga zale mithi?
Njengazo zonke iziyobisi, ii-DMARD zinokuba nemiphumo emibi. Ezinye zincinci, ngelixa ezinye zinokuba yingozi. Ngoko ke thetha nogqirha wakho ngazo ngaphambi kokuba uqale amayeza.
- Ii-biologics kunye nee-JAK inhibitors: Ezi zicothisa inkqubo yomzimba yokuzikhusela, nto leyo eyenza ingakwazi ukulwa nezifo. Ke ngoko, kubalulekile ukuqinisekisa ukuba unolwazi olupheleleyo ngazo zonke izitofu zakho zokugonya ngaphambi kokuba uqale la mayeza.
- Uvavanyo lweSifo sePhepha (TB): Kubalulekile ukuba uvavanyelwe isifo sePhepha (TB) ngaphambi kokuba uqale amayeza okuthintela i-TNF, njengoko la mayeza anokuvuselela iintsholongwane ze-TB ezingasebenziyo emzimbeni wakho.
- Ezinye iziphumo ebezingalindelekanga: Ukuba bomvu kwindawo ehlatywe kuyo inaliti, intloko ebuhlungu, kunye nokurhawuzelela kolusu kunokwenzeka. Izithinteli ze-IL-17 ngamanye amaxesha zinokwenza i-IBD ibe mandundu ngakumbi.
Iziphumo ebezingalindelekanga ze-DMARD zemveli
- I-Methotrexate: Ukuphazamiseka kwesisu, izilonda zomlomo, kunye nokubalwa kweeseli zegazi ezisezantsi kunokubangela usulelo, umkhuhlane, kunye nokukrweleka. Ukunciphisa oku, ugqirha wakho uza kukunika iipilisi ze-folic acid. Ngelixa usela eli yeza , kuya kufuneka wenze uvavanyo lwegazi rhoqo emva kweenyanga ezi-1-3 ukujonga ukusebenza kwezintso zakho kunye nesibindi. Eli yeza alikhuthazwa ngexesha lokukhulelwa.
- I-Sulfasalazine: Isicaphucaphu, ukuhlanza, ukuva ukukhanya kwelanga, ukurhawuzelelwa lusu, kunye nentloko ebuhlungu kunokwenzeka. Eli yeza lingenza umchamo wakho ujike, ubile, kwaye likrazule umbala otyheli-orenji. Alinabungozi, kodwa linokungcolisa impahla.
Eyona nto ibalulekileyo kukuba ungoyiki ukuba ufumana naziphi na iziphumo ebezingalindelekanga kwaye wazise ugqirha wakho ngoko nangoko.
Yintoni onokuyilindela xa uqala unyango?
La mayeza awasebenzi ngendlela efanayo kuye wonke umntu. Fumana iziphumoKungathatha iiveki ezimbalwa okanye inyanga okanye ezimbini. Ngoko ke kubalulekile ukuba nomonde. Musa ukuyeka ngequbuliso ukuthatha amayeza kuba ucinga ukuba awazukuba ngcono.
Kwakhona, nokuba iimpawu zakho ziphelile ngokupheleleyo, kubaluleke kakhulu ukuqhubeka nokusela amayeza akho logama nje ugqirha wakho ekuxelele ukuba wenjenjalo. Ukuba uyeka, isifo sinokuphinda sivele kwakhona.
Umyalezo Wokuya Ekhaya
- Ii-DMARD azifani neepilisi zokudambisa iintlungu eziqhelekileyo. Ukongeza ekunciphiseni iintlungu, zikwalawula ukuqhubela phambili kwesi sifo kwaye zithintele ukonakala kwamalungu.
- Kukho iintlobo ezahlukeneyo, ezifana ne-biologics, i-JAK inhibitors, kunye ne-DMARD zemveli. Ugqirha wakho uya kukhetha amayeza afanele imeko yakho.
- Ngenxa yokuba la mayeza ayayicinezela inkqubo yomzimba yokuzikhusela, kukho umngcipheko wokosuleleka. Uvavanyo lwesifo sephepha (TB) luyimfuneko ngaphambi kokuba uqale amayeza okuthintela i-TNF.
- Kuthatha ixesha ukubona iziphumo, ngoko ke yiba nomonde ngonyango lwakho. Nokuba iimpawu zakho ziyancipha, ungayeki ukuthatha amayeza ngaphandle kwengcebiso kagqirha wakho.
- Ukuba ufumana naziphi na iziphumo ebezingalindelekanga okanye uneengxaki, thetha nogqirha wakho ngoko nangoko.
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