Inkcazo yeziyobisi "Vikeira Pak". Iingxelo zokuphathwa, ukusebenzisa i-Viekira Pak

Isilwanyana sesizukulwana esitsha esivela kwi-hepatitis C "I-Wikeyra Pak" ihlaziywa kwiimeko ezininzi ezintle. Oku kubangelwe ikakhulu ekusebenzeni okuphezulu kweziyobisi.

Isenzo sesilwanyana "Vikeira Pak"

Isenzo sonyango sisekelwe kumalungiselelo amathathu omhlobo we-anti-virus. Ezi zi "Dasabuvir", "i-Ombitasvir", kunye ne-ritonavir "Paritaprevir". Njengesiza esidumileyo sehlabathi esibizwa ngokuba yi "Harvoni", "iViqueira Pak" inekhono eliphezulu lokunyanga - ixesha eliphakathi kwe-97 ukuya kuma-99%. Isilwanyana esivela ku-hepatitis sesine esivunyelwe eMelika. Ngaphambi kwayo, iimvavanyo zeklinikhi zagqitywa ngokugqithiseleyo "u-Olizio" (igama eRussia "iSovriad"), lidibaniswe "Harvoni", kwaye "neSowaldi".

Ulwazi olubanzi malunga nomkhiqizo omtsha wezonyango

"I-Vikeira Pak" (ukuhlolwa kwakungekho kuninzi kakhulu, ekubeni isichengisiso sabhaliswe eRashiya kuphela ngoMeyi 2015) senziwa ngumvelisi wase-Ireland, kodwa ihlanganiswe e-United States of America. Isilwanyana eRashiya sithengiswa ngokusemthethweni, sinokuyalelwa kuyo nayiphi na ikhemisi. Izinto ezisebenzayo zonyango:

• Ritonavir;
• Dasabuwir;
• Paritrapeprir;
• Ombitasvir.

Ukubhekiselele kumachiza antiviral of action ngqo (J05A). Eli mayeza liyeza kakhulu. Ngokomzekelo, inkqubo yokonyango kweeveki ezili-12 iya kubiza i-ruble ezili-950 zamawaka-iipakethi ezimbalwa "iVielaira Pak" (indleko eSt. Petersburg). Ukuhlaziywa kwabaThengi kubandakanya ulwazi, xa kuthelekiswa ne-"Harvoni" edumeleyo, ixabiso layo eYurophu lingama-dollar angama-60, i-Irish drug still is available for the purchase. Inketho enkulu yebhajethi phakathi kwazo zonke izidakamizwa ezifanayo ezibizwa ngokuthi "i-Sunvepra" (ixabiso li-ruble eziyi-400 zamawaka ngekhosi yokunyanga kwexesha elifanayo).

Imigomo nemeko yokugcina

Inkcazo epheleleyo yeziyobisi "Vikeira Pak" ingafundwa kwipakethe kunye neyeza. Gcina kwindawo engenafikeleleki kubantwana kwiqondo lokushisa elingama-25 degrees Celsius. Musa ukuthatha isilwanyana emva komhla wokuphela kweminyaka emi-2. Yonke ingcaciso malunga ne "Vikeira Pak" ithetha: intengo, imiyalelo yokusetyenziswa, ukuphononongwa kwabantu abaphantsi kokonyango ngala mayeza, shwa nkathelwe kweli nqaku.

Ukusetyenziswa kwe "Vicair Park" kunye nemiphumo emibi

Ukwamkelwa kwesilwanyana esibuzwayo ukuba unyango lwe-hepatitis C kufuneka lwenziwe ngexesha lokutya, ngelixa umxholo wekhalori okanye umxholo weoli ochaphazelekayo awunandaba. Ngentsasa, iipilisi ezimbini zeparitrapeprir / ritonavir / ombitasvir, kunye neepilisi enye yedasabuwir kufuneka ithathwe. Okukugqibela kufuneka kusetyenziswe kusihlwa. Kwezinye izigulane, ugqirha ukhetha "iVicair Park" kunye ne "Ribavirin". Ukuba lolu khetho lukhethwa, "i-Vichera Pak" ithathwa kwisixa semathebhulethi ayisithupha ngosuku:

• Ngethuba lokusa lusuku - i-tablet enye emnyama kunye nokukhanya kabini;
• Ngobusuku omnye mnyama;
• Ngesibini ngosuku, "Ribavirin" kwisilinganiso se-500 mg.

Ukusetyenziswa kwe "Vikeira Pak" (ukuphononongwa kuquka iigqabazo zeengcali ezinolwazi) kufuneka kuvunyelwane kunye nogqirha nakanjani. Ukuba isigulane sijamelana nokusuleleka nge-HIV, ke i-regimen yezilwanyana ihlala yinto efanayo, kunye, ngokufanelekileyo-ngexesha lokutya. Kwiphakheji akukho miphumo embi kakhulu ekuthathweni kwamachiza. Ukugqithiswa okuqhelekileyo kunokwenzeka, ukugweba ngempendulo kunye nemiyalelo, kukuba:

• Asthenia;
• Ukuphendula kwesikhumba, kuquka ukubetha;
• Ukukhathala ngokukhawuleza;
• Ukungabi nobuthongo;
• Isihlunu.

Inkqubo yokwenza unyango

Ulungiso lwe "Vichera Pak", i-regimen yonyango luquka ukudibanisa kwamayeza amathathu aqhutywe yinkampani "EbbVay", kunye ne-enhancer-type-enhancer called "Ritonavir". I-regimen yeyeza ukuba unyango lwe-hepatitis C imiselwe ukwelashwa kwe-HCV (i-genotype 1a) kunye neRibavirin. Ikhosi kufuneka ibe ngeeveki ezili-12 ezipheleleyo. Kwi-genotype 1b, unyango lufana, kodwa ngaphandle kokubandakanya izidakamizwa zokugqibela. Ukongeza, i-"Vikeira Pak" (ukuphononongwa okuphathwa ngolu hlobo lukhangeleka ngaphezu kokuthakazelisa) kulungiselelwe unyango lwezigulane ezine-cirrhosis ezihlawulwe. Ikhosi iiveki ezingama-24 kunye ne "Ribavirin" ye-genotype 1a, kwezinye iimeko - iiveki ezili-12.

Impendulo ephilileyo ye-virologic kwizigulane (kunye ne-genotype 1a) ngokungabikho kwe-cirrhosis yafunyanwa kwi-97% yamatyala, kwaye kwi-1b-100% ngenqaku lokuba unyango luhlobo lodibeneyo. Nge-cirrhosis ehlawulelweyo yesibindi, i-SVR yafikelela kuma-95% (unyango lwadlulayo kwiiveki ezingama-24) kwii-genotype 1a, kwezinye iimeko (1b) uphawu lufikile kwikhulu leepesenti.

Ukungqinelana okukhoyo

Isilwanyana "Vikeira Pak" (ukuphononongwa okuphathwe oku kuqinisekisiweyo), njengalowo naluphi na iziyobisi, uninzi lweengqinisiso. Ezi ziquka oku kulandelayo:

• Ukuhlaziywa komsebenzi we-hepatic;
• Ukunyanzelisa u-ritonavir;
• Hemoglobinopathy;
• Unyango olulodwa kunye ne "didanosine";
• Ukukhulelwa;
• Ukuthatha inhibitors ezinamandla;
• Ukwamkelwa kwezixhobo ezinamandla.

Kufuneka kuqatshelwe ukuba ukusetyenziswa kwemveliso yezonyango kubantwana abangaphantsi kweminyaka yobudala kunqatshelwe. Ukongezelela, ngexesha lokuhlambalaza, inkqubo yonyango yowesifazane ayikhuthazwa ngenxa yokungabi nalwazi oluchanileyo malunga nokungena kwezinto ezisebenzayo ze-"Viqueira Pak" kwibisi yobisi. Kubalulekile ukuyeka ukuncelisa.

Isilumkiso ekusebenziseni

I-American Office yokuLawula ukuLungiswa kweeMpilo ibika ingxelo yokuba iVielaira ne-analogs ezisetyenziselwa ukuphatha i-hepatitis C zingakhokelela ekulimaleni komonakalo wesibindi. Ngokukodwa kubandakanyeka ngabantu abaneempembelelo emsebenzini wendima ebalulekileyo. Ngenxa yesi sizathu, umenzi wenze izilungiso ezithile kwimigaqo yokusetyenziswa kwemveliso yeyeza.

Ukuba isigulane sibona ukuba ukhathala rhoqo kunye nokukhathala kwenzeka ngexesha lonyango, i-dizzy, ukuhlanza nokuhlanza rhoqo, kwaye ulusu luqala ukuba luphuzi, kuyimfuneko ukufuna uncedo kwi-ingcali kuba kukho ukulimala kwesibindi. Ukuyeka ukuthatha isidakamizwa ngaphandle kokuthintana nogqirha akukho nangoko kwenzeka, njengoko oku kungakhokelela ekukhuseni kwezinye iziyobisi ezilwa ne-hepatitis. Ugqirha esibhedlele kufuneka agcine isigulane ixesha elithile ukuba angabandakanyi iimpawu zokuphazamiseka esibindi. Ezi ziquka:

• Ukuhlambalaza kwiimvumba ezixubileyo;
• Ascites;
• Ukwandisa amazinga e-bilirubin;
• Encephalopathy.

Ezi zonyango ezifana ne "Vikeira Pak", zinegalelo ekunciphiseni okuninzi kwisifo sentsholongwane ka-hepatitis C emzimbeni womntu, ngaphezu koko, kunokunciphisa ukuqhubeka kwesifo.

Ukutyunjwa kwezigulane ezinezilwanyana ezisuka kwi-hepatitis C

Iimpawu zonyango lwe-Viekira Pak ziquka ukudibanisa kwamanani athile eziyobisi ezisetyenziswayo kunye ne "Ribavirin" okanye ngaphandle. Isilwanyana savunywa ukuba unyango lwezigulane ezinobungqina be-cirrhosis zesibindi kunye nesifo esingapheliyo sesifo se-hepatitis C. Ngaphambi kokusebenzisa le mayeza, kubalulekile ukuxelela ugqirha malunga nale ilandelayo:

• Kukho ukusuleleka kwe-HIV;
• Ngezinye izifo zesibindi, ngaphezu kwe-hepatitis C;
• Kusetyenziswa kwezinto zokukhusela, kuquka i-ethinyl estradiol.

Kufuneka kuqatshelwe ukuba kwiimeko ezininzi, imiphumo emibi ekuthathweni kwezidakamizwa iyakubetha kunye nokucaphuka kwesikhumba, ukungabikho kokulala nokucela ukuhlanza. Ngokweedatha ukususela ngo-2015, oogqirha bezempilo baye bamisela isilwanyana esibizwa ngokuba yi "Viqueira Pak" kubantu abangaphezu kwe-11 000.

Yintoni kufuneka isigulane esiphila kunyango siyazi?

Ukuba isigulane singena kwikhosi ye-12 okanye ye-24 yonyango, ayikwazi ukumiswa ngaphandle kokubonisana nodokotela. Oku kunokukhokelela ekukhuseni komzimba kwamanye amayeza-afana. Kufanelekile ukukhumbula ukuba ukuba isigulane sinesigxina esiphambili se-pathology fovergy, "i-Vichera Pak" inokukhokelela kumonakalo omkhulu wegciwane, kuquka ukungafihleki kwe-hepatic. Qinisekisa ukuba ufuna uncedo esibhedlele ukuba ubona ukuphindaphinda rhoqo kweempawu ezifana nokuhlanza, ukuphuka okwesibhakabhaka kwesiplera, ukulahleka kokutya okungaxeliweyo, umbala wombala wokukhanya.

Ngaphambi kokuba uqale inkqubo yokonyango, kucetyiswa ukuba ufunde imiyalelo. Nayiphi na imibuzo kufuneka ixoxwe kunye nogqirha wakho. Awukwazi ukunqanda naluphi na ulwazi malunga nempilo yakho, kubandakanywa nemiphumo emibi evela ekubeni uthathe iVikaira Pak.

Uhlolo lo khu seleko

Ukukhuselwa kweziyobisi zaseViiraira kuhlolwe ngokusekelwe kwingxelo yesigaba sesibini nesithathu sezilingo zeeklinikhi kwizigulana ezingama-3,000 ezithatha unyango kunye neRibavirin kwaye ngaphandle. Idata nazo zaqwalaselwa phakathi kwezigulane ezinobungqina be-cirrhosis yesibindi. Impendulo engafanelekanga ukusuka ekusebenziseni yabonwa kwi-20% yamatyala. Iimpawu eziqhelekileyo zisohlwayo kunye nokukhathala okukhulu. Ukunyanga ukunyanga ngenxa yemiphumo emibi ye-1.15% kuphela. Ukuqalisa kwakhona emva kokuphazamiseka kweyeza-1.4%. Ngenxa yokungahambi kakuhle komzimba kwisilwanyana, kwakudingeka ukunciphisa umlinganiselo we "Ribavirin" kwi-8% yezigulane.

Ukungafani kwimpendulo yomzimba kwisigulane kwizigulane ezine-cirrhosis kwaye ngaphandle kwayo akuzange kugcinwe. Ucwaningo lwekliniki lubandakanya izigulana ezithatha iViiraira Pak kunye neRibavirin. Ukuphawula kuphela ukusetyenziswa kweziyobisi kulo mzekelo kubakho ukutshitshiswa kwesikhumba. Ukuyeka unyango ngenxa yesi sizathu, kuphela i-0.4%, ikhefu lokunyanga elenziwe malunga ne-0.6% yezigulane. Ukuvavanywa kokukhuselwa kweziyobisi "Vikeira Pak" kwaqhutyelwa kwiipameters eziliqela (nge-cirrhosis kwaye ngaphandle, ngokudibaniswa kwe "Ribavirin" kwaye akukho) kunye nayo yonke inkambo yokwelapha, iiveki ezili-12 kunye ne-24.

Iindleko ezimalunga ne "Vikeira Pak" eRashiya nakwamanye amazwe

EUnited States, i-Vikeira Pak ixabisa malunga ne-84,000 yee-(kwimizuzu eyi-12 yonyango), umgaqo-mali kwiRussia Federation, njengamazwe amaninzi aseYurophu, ahluke kakhulu.

Kwii-portal ezahlukeneyo kwi-Intanethi ungabona iindleko ezahlukileyo zemveliso yezokwelapha zase-Ireland. Amaziko ezonyango eRashiya, iindleko ze "Vikeira Pak" zingama-ruble amawaka angama-300 ngenyanga yonyango. Kwikhosi yeeveki ezili-12, kuya kufuneka uhlawule malunga nee-ruble eziyi-850-900 zamawaka. Ngaloo ndlela, abo banqunywe unyango kwiiveki ezingama-24, baya kufuna ukufumana unyango lwe-hepatitis C ezingekho ngaphantsi kwama-ruble ayi-1.5 million.