Izidakamizwa Ezihlosiwe Ibrutinib: Yini Oyaziyo - I-AASraw
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Ibrutinib

  1. Izidakamizwa Ezihlosiwe Ibrutinib (CAS: 936563-96-1)
  2. Ibrutinib Mechanism of Action
  3. Lokho Ibrutinib Isetshenziselwa kona
  4. Izinzuzo / Imiphumela ye-Ibrutinib
  5. Kufanele Sithathe Kanjani Ibrutinib
  6. Imiphumela emibi ye-Ibrutinib
  7. Isitoreji se-Ibrutinib

Izidakamizwa Ezihlosiwe Ibrutinib(I-CAS: 936563-96-1)

Izindlela eziningi zokwelapha ezintsha ze-lymphoma yizidakamizwa ezibhekiswe kuzo. Izidakamizwa ezihlosiwe kuhlose ukubulala uhlobo lweseli oluphenduke umdlavuza noma ukumisa amasignali okwenza amangqamuzana anomdlavuza akhule noma ahlukane. E-lymphoma, uhlobo lweseli oluba nomdlavuza lubizwa nge- "lymphocyte" (uhlobo lweseli elimhlophe elilwa nokutheleleka). Kunezinhlobo eziningana ze-lymphocyte ezingaba nomdlavuza. Ibrutinib ihlose ama-lymphocyte B (amaseli B) ngakho-ke isetshenziselwa ukwelapha i-B-cell lymphomas.

Amaseli athumela futhi amukele amasiginali kwamanye amaseli. Eminye yale mibonakaliso igcina amangqamuzana ephila futhi iwahlukanise. Ziningi izindlela zokusayina futhi amasiginali athunyelwa ngakunye noma ngaphezulu kwalezi zindlela. Ibrutinib yisiginali yesiginali yeseli ekhomba iprotheni ebizwa nge 'Bruton' s tyrosine kinase '(BTK). I-BTK iyingxenye yendlela esiza ama-B cell ukuthi ahlale ephila futhi ahlukane. Ukuvimba i-BTK kungenza amaseli we-B afe noma awavimbe ahlukane. Le ndlela yokwelashwa ingavimba ukusabalala kwamangqamuzana B anomdlavuza.

 

Ibrutinib Indlela Yokusebenza

Ibrutinib (936563-96-1) akuyona umuthi wokwelapha ngamakhemikhali kodwa ungomunye walokho okubizwa ngokuthi “izindlela zokwelapha ezihlosiwe.” Ukwelashwa okuhlosiwe kungumphumela weminyaka yocwaningo olunikezelwe ukuqonda umehluko phakathi kwamaseli womdlavuza namaseli ajwayelekile. Kuze kube manje, ukwelashwa komdlavuza kugxile kakhulu ekubulaleni amaseli ahlukanisa ngokushesha ngoba isici esisodwa samaseli womdlavuza ukuthi ahlukana ngokushesha. Ngeshwa, amanye amangqamuzana ethu ajwayelekile ahlukana ngokushesha futhi, abangele imiphumela emibi eminingi.

Ukwelashwa okuhlosiwe mayelana nokukhomba ezinye izici zamangqamuzana omdlavuza. Ososayensi bafuna ukungezwani okwehlukile kumangqamuzana omdlavuza namaseli avamile. Lolu lwazi lisetshenziselwa ukwakha ukwelashwa okuhlosiwe ukuhlasela amangqamuzana omdlavuza ngaphandle kokulimaza amangqamuzana avamile, ngaleyo ndlela eholele emiphumeleni emincane emibi. Uhlobo ngalunye lwe-therapy olubhekiswe lusebenza kancane kancane kodwa konke kuphazamisa ikhono lomdlavuza wesifo sokukhula, ukwahlukanisa, ukukhanda kanye / noma ukuxhumana namanye amaseli.

Ibrutinib ivimbela ukusebenza kweBruton's tyrosine kinase (BTK). I-BTK iyi-molecule ekhombisa ukhiye yesakhiwo sokukhomba se-B-cell esidlala indima ebalulekile ekusindeni kwamangqamuzana ama-B amabi. Ibrutinib ivimba amasiginali akhuthaza amangqamuzana ama-B amabi ukuba akhule futhi ahlukane ngokungalawuleki. Ucwaningo luyaqhubeka nokuhlonza ukuthi imaphi umdlavuza ongelashwa kangcono ngezindlela zokwelashwa ezihlosiwe nokuhlonza izinhloso ezingeziwe zezinhlobo eziningi zomdlavuza.

Qaphela: Sikukhuthaza ngokuqinile ukuthi ukhulume nochwepheshe wakho wezokunakekelwa kwezempilo ngesimo sakho esithile sezokwelapha nokwelashwa. Imininingwane equkethwe yile webhusayithi yenzelwe ukuba ibe wusizo futhi ifundise, kepha ayithathi indawo yezeluleko zezokwelapha.

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Lokho Ibrutinib Isetshenziselwa kona

Treat Ukwelapha abantu abane-mantle cell lymphoma (MCL; umdlavuza okhula ngokushesha oqala kumaseli amasosha omzimba) asebevele belashwa okungenani ngomunye umuthi wokwelashwa ngamakhemikhali.

Treat Ukwelapha abantu nge i-lymphocytic leukemia engapheli (CLL; uhlobo lomdlavuza oqala kumaseli amhlophe egazi) kanye ne-lymphocytic lymphoma (SLL; uhlobo lomdlavuza oqala kakhulu kuma-lymph node).

❸ Ukwelapha abantu abane-Waldenstrom's macroglobulinemia (WM; umdlavuza okhula kancane oqala kumaseli athile amhlophe egazi emnkantsheni wakho).

❹ Ukwelapha abantu abane-marginal zone lymphoma (MZL; umdlavuza okhula kancane oqala ngohlobo lwamaseli amhlophe egazi ngokuvamile alwa nokutheleleka) asebevele belashwa ngohlobo oluthile lwemithi yokwelashwa ngamakhemikhali.

Treat Ukwelapha abantu abanesifo esingapheli se-graft vs host disease (i-cGVHD; inkinga yokufakwa kwe-hematopoietic stem-cell transplant [HSCT; inqubo ebuyisela umongo wethambo onesifo ngomnkantsha onempilo] engaqala isikhashana ngemuva kokufakelwa futhi ihlale isikhathi eside ) ngemuva kokuphathwa ngokungaphumeleli ngemithi e-1 noma ngaphezulu.

U-Ibrutinib usesigabeni semithi ebizwa nge-kinase inhibitors. Isebenza ngokuvimba ukusebenza kweprotheni engavamile ekhombisa ukuthi amangqamuzana omdlavuza ayanda. Lokhu kusiza ukunqanda ukusabalala kwamangqamuzana omdlavuza.

Ibrutinib

Ibrutinib Izinzuzo/ Imiphumela

Ibrutinib ibhekwa ngochwepheshe abaningi ukuthi 'iyindlela yokwelashwa okuphumelelayo' kwezinye izinhlobo ze-lymphoma. Inikeza amazinga okuphendula aphezulu uma kuqhathaniswa nezinye izindlela zokwelapha zezinhlobo ezifanayo ze-lymphoma. Izilingo ezinkulu eziholele ekuvunyelweni kwe-ibrutinib zichazwe kafushane ngezansi.

 

(1) Izinzuzo ze-mantle cell lymphoma

I-Mantle cell lymphoma ebuyile noma engaphendulanga ekwelashweni komugqa wokuqala kungaba nzima ukuyelapha. Kodwa-ke, ucwaningo oluyinhloko kule ndawo lubonise ukuthi ngaphezu kwengxenye yesibili kwabathathu yabantu abayi-111 abaphathwe nge-ibrutinib baphendule ekwelashweni (i-lymphoma shrank noma yanyamalala).

Ucwaningo lwesibili kubantu abangama-280 luqhathanisa ibrutinib nomunye umuthi womdlavuza, i-temsirolimus, kubantu abane-mantle cell ebuyile noma ephikisayo. Abantu baphila isilinganiso sezinyanga eziyi-15 ngaphandle kokuthi i-lymphoma yabo iye iba yimbi kakhulu lapho belashwa nge-ibrutinib uma kuqhathaniswa nesilinganiso sezinyanga eziyisithupha lapho belashwa nge-temsirolimus.

 

(2) Izinzuzo ze-lymphocytic leukemia (CLL)

Izimpendulo ezihlala isikhathi eside zibonakale kubantu abane-CLL abaphathwa nge-ibrutinib. Esivivinyweni esikhulu esithinta abantu abangama-391 abane-CLL ebuyile noma enqabile, ibrutinib yaqhathaniswa ne-ofatumumab, evame ukusetshenziselwa abantu abane-CLL ababuyile. Ngonyaka owodwa ngemuva kokuqala ukwelashwa, cishe abantu abangama-66 kwabangu-100 abathatha ibrutinib babene-CLL eyayikade ilawulwa (lokhu kubizwa ngokuthi 'ukuqhubeka nokuphila ngaphandle kokuqhubeka') uma kuqhathaniswa nabantu abayisithupha kwabangu-6 abaphathwa nge-ofatumumab.

Ocwaningweni lwesibili olubandakanya abantu abangama-269 ababengakatholi ukwelashwa nge-CLL yabo, ibrutinib yaqhathaniswa ne-chemotherapy drug chlorambucil. Ngemuva kweminyaka engu-1.5 yokwelashwa, cishe abantu abangama-90 kwabangu-100 abathatha ibrutinib babene-CLL eyayikade ilawulwa ngokuqhathaniswa nabantu abangaba ngu-52 kwabangu-100 abaphathwa nge-chlorambucil.

Ukungeza ibrutinib ku-bendamustine kanye ne-rituximab yabantu abane-CLL ebuyile noma ephikisayo nakho kuphumelele ocwaningweni oluthinta abantu abangama-578. Ubungozi bokuqhubeka kwe-CLL bancishiswa ngokuthatha i-ibrutinib esikhundleni se-placebo (ukwelashwa kwesidumbu).

 

(3) Izinzuzo eWaldenström' i-macroglobulinaemia (WM)

Izinga eliphezulu lokuphendula liye labonakala kubantu abane-WM - cishe abantu abayi-9 kwabangu-10 abane-WM abaphendulile ukwelashwa ibrutinib ecaleni elingu-63. Lokhu kuhlolwa kube yintuthuko enkulu kwi-WM njengoba kuyindlela engajwayelekile ye-lymphoma ngakho-ke kunzima ukuthola abantu abanele ukuthi babambe iqhaza esivivinyweni somtholampilo. Leli cala laholela ekwamukelweni kwe-ibrutinib ye-WM eYurophu.

 

Kufanele Sithathe Kanjani Ibrutinib 

Uzonikezwa ibrutinib njengamaphilisi. Inganikezwa ihlangene nezinye izidakamizwa zokwelashwa ezihlosiwe kanye ne-chemotherapy. Ngesikhathi sokwelashwa uvame ukubona udokotela we-cance¬r, umhlengikazi womdlavuza noma umhlengikazi onguchwepheshe, kanye nosokhemisi onguchwepheshe. Lokhu kusho ukuthi uma sisho udokotela, umhlengikazi noma usokhemisi kulolu lwazi.

Ngaphambi noma ngosuku lokwelashwa, umhlengikazi noma umuntu oqeqeshwe ukuthatha igazi (i-phlebotomist) uzothatha isampula segazi kuwe. Lokhu kuhlolwe ukuthi amaseli akho egazi asezingeni eliphephile yini ukuze uthole ukwelashwa.

Uzobona udokotela noma umhlengikazi ngaphambi kokuba uthole ukwelashwa. Bazokubuza ukuthi ubuzizwa kanjani. Uma imiphumela yegazi lakho ilungile, usokhemisi uzolungiselela ukwelashwa kwakho. Umhlengikazi wakho uzokutshela ukuthi ukwelashwa kwakho kungenzeka kube sekulungile nini.

Umhlengikazi noma usokhemisi bazokunikeza amaphilisi e-ibrutinib ukuthi uye nawo ekhaya. Ngaso sonke isikhathi thatha njengoba nje kuchaziwe. Lokhu kubalulekile ukuqinisekisa ukuthi bakusebenzela kahle ngangokunokwenzeka. Unganikezwa amaphilisi ezinamandla ahlukene. Uvamise ukugcina ukuthatha ibrutinib nsuku zonke inqobo nje uma igcina umdlavuza ulawulwa. Umhlengikazi noma usokhemisi wakho angakunika nemithi yokulwa nokugula neminye imithi ozohamba nayo uye ekhaya. Thatha wonke amaphilisi wakho njengoba nje echazisiwe.

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Isikhumbuzi Esifudumele ku Ukuzinakekela

♦ Ngenkathi uthatha ibrutinib, phuza okungenani amalitha amabili ketshezi njalo emahoreni angama-24, ngaphandle kwalapho uyalelwa ngenye indlela.

♦ Geza izandla zakho njalo nangemuva kokuthatha umthamo ngamunye we-ibrutinib.

May Ungaba sengozini yokutheleleka ngakho-ke zama ukugwema izixuku noma abantu abanemikhuhlane, futhi ubike umkhuhlane nanoma yiziphi ezinye izimpawu zokutheleleka ngokushesha kumhlinzeki wakho wezokunakekelwa kwempilo.

♦ Ukusiza ukwelapha / ukuvimbela izilonda zomlomo ngenkathi uthatha ibrutinib, sebenzisa isixubho esithambile, bese ugeza kathathu ngosuku nge-1 ithisipuni yesoda yokubhaka exutshwe nama-ounces ayisishiyagalombili amanzi.

An Sebenzisa insingo kagesi nebhulashi lamazinyo elithambile ukunciphisa ukopha.

♦ Gwema ukuxhumana nemidlalo noma nemisebenzi engadala ukulimala.

♦ Ukwehlisa isicanucanu, phuza imishanguzo yokulwa nesicanucanu njengoba kuchazwe ngudokotela wakho, futhi udle ukudla okuncane, okuvamile ngenkathi uthatha ibrutinib.

At Yidla ukudla okungasiza ekunciphiseni isifo sohudo-bheka Ukuphatha imiphumela emibi - Uhudo

♦ Landela uhlobo lwemithi elwa nohudo njengoba kunqunyelwe uchwepheshe wezokunakekelwa kwempilo.

♦ Gwema ukushiswa yilanga. Gqoka i-block block ye-SPF 15 (noma ngaphezulu) nezingubo zokuzivikela. Ibrutinib ingakwenza uzwele kakhulu elangeni futhi ungashiswa yilanga kalula.

♦ Ngokuvamile, ukuphuza iziphuzo ezidakayo kufanele kugcinwe okungenani noma kugwenywe ngokuphelele ngenkathi uthatha ibrutinib. Kufanele uxoxe nodokotela wakho ngalokhu.

♦ Phumula ngokwanele.

♦ Gcina umsoco omuhle ngenkathi uphathwa nge-ibrutinib.

You Uma uhlangabezana nezimpawu noma imiphumela emibi ngenkathi welashwa nge-ibrutinib, qiniseka ukuthi uxoxa ngazo nethimba lakho lokunakekelwa kwezempilo. Bangabeka imishanguzo kanye / noma banikeze ezinye iziphakamiso eziphumelelayo ekulawuleni izinkinga ezinjalo.

 

Ibrutinib Si-ide Ekuthinta

Thola usizo lwezokwelapha oluphuthumayo uma unesibonakaliso sokusabela okweqile: imihlathi; ukuphefumula okunzima; ukuvuvukala kobuso bakho, izindebe, ulimi, noma umphimbo.

 

Yeka ukusebenzisa ibrutinib bese ushayela udokotela wakho ngasikhathi sinye uma une:

♦ Izimpawu zokutheleleka- umkhuhlane, amakhaza, ubuthakathaka, izilonda zomlomo, ukukhwehlela ngamafinyila, ukuphefumula kanzima;

♦ Izimpawu zokopha ngaphakathi emzimbeni wakho — isiyezi, ubuthakathaka, ukudideka, izinkinga ngokukhuluma, ukuphathwa yikhanda isikhathi eside, indle emnyama noma enegazi, umchamo obomvana noma onsundu, noma ukukhwehlela igazi noma ukugabha okubukeka njengezindawo zekhofi;

Di Uhudo olunamandla noma oluqhubekayo;

Pain Ubuhlungu besifuba, ukushaya kwenhliziyo noma ukushaya esifubeni sakho, uzizwe sengathi ungadlula;

Headache Ukuphathwa ikhanda elibuhlungu, ukungaboni kahle, ukushaya entanyeni noma ezindlebeni zakho;

Br Ukulimala okulula, ukopha okungavamile, amabala ansomi noma abomvu ngaphansi kwesikhumba sakho;

Skin Isikhumba esiphaphathekile, izandla nezinyawo ezibandayo;

Problems Izinkinga zezinso –ukuchama okuncane noma cha, ukuvuvukala ezinyaweni noma emaqakaleni; noma

♦ Izimpawu zokuwohloka kwamangqamuzana omzimba – ukudideka, ukuba buthakathaka kwemisipha, isicanucanu, ukuhlanza, ukushaya kwenhliziyo okusheshayo noma okuhamba kancane, ukuncipha kokuchama, ukuncinza ezandleni nasezinyaweni noma emlonyeni wakho.

 

Imiphumela emibi evamile ingafaka:

♦ Uhudo, isicanucanu;

Umkhuhlane, ukukhwehlela, ukuphefumula kanzima;

Isters Amabhamuza noma izilonda emlonyeni wakho;

♦ Ukuzizwa ukhathele;

Ru Ukuqubuka, ukuqubuka; noma

Ubuhlungu bemisipha, ubuhlungu bamathambo.

Lokhu akulona uhlu oluphelele lwemiphumela emibi kanti abanye bangase bavele. Shayela udokotela wakho iseluleko sezokwelapha mayelana nemiphumela emibi. Ungabika imiphumela emibi ku-FDA ku-1-800-FDA-1088.

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Ibrutinib Sukuhlushwa

Gcina i-Ibrutinib esitsheni efike ngayo, ivalwe ngokuqinile, futhi lapho izingane zingafinyeleleki khona. Yigcine ekamelweni lokushisa kude nokukhanya, ukushisa okweqile nomswakama hhayi endlini yangasese.

Ibrutinib engadingeki kufanele ilahlwe ngezindlela ezikhethekile zokuqinisekisa ukuthi izilwane ezifuywayo, izingane, nabanye abantu abakwazi ukuzidla. Kodwa-ke, akufanele usebenzise le Ibrutinib phansi endlini yangasese. Esikhundleni salokho, indlela engcono kakhulu yokulahla imithi yakho ngohlelo lokubuyisa umuthi. Khuluma nosokhemisi wakho noma uthinte umnyango wangakini wokulahla udoti / wokusebenzisa kabusha ukuze ufunde ngezinhlelo zokubuyisela emuva emphakathini wakho. Bona Ukulahlwa Okuphephile kwe-FDA kwe-

Kubalulekile ukugcina zonke izidakamizwa zingaboni futhi zifinyelele ezinganeni iziqukathi eziningi (njengezimpilisi zamasonto onke kanye nalawo amaconsi amaso, ama-creams, ama-patches, nama-inhalers) akuzona izingane ezingamelana nazo futhi izingane ezincane zingazivula kalula. Ukuze uvikele izingane ezincane ebuchosini, zihlale zikhiya izinhlamvu zokuphepha futhi zibeke ngokushesha imithi endaweni ephephile - ephezulu futhi ephuma futhi engaboni futhi efinyelele.

 

Izikhombo

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[4] UMato AR, uHill BT, uLamanna N, et al. Ukulandelana kahle kwe-ibrutinib, i-idelalisib, ne-venetoclax ku-leukemia engapheli ye-lymphocytic: imiphumela yocwaningo oluningi lweziguli ezingama-683. U-Ann Oncol. 2017; 28 (5): 1050-1056.

[5] UWoyach JA, uRuppert AS, uGuinn D, et al. Ukumelana kwe-BTKC481S ne-ibrutinib ku-leukemia engapheli ye-lymphocytic. J Clin Oncol. 2017; 35 (13): 1437-1443.

[6] UWinqvist M, Asklid A, Andersson PO, et al. Imiphumela yangempela yomhlaba ye-ibrutinib ezigulini ezine-leukemia engapheli futhi eqhubekayo ye-lymphocytic leukemia: idatha evela ezigulini ezingama-95 ezilandelanayo eziphathwe ohlelweni lokusebenzisa uzwela. Isifundo esivela eSweden Chronic Lymphocytic Leukemia Group. I-Haematologica. 2016; 101 (12): 1573-1580.

[7] UJones JA, uHillmen P, uCoutre S, et al. Ukusetshenziswa kwama-anticoagulants kanye ne-antiplatelet ezigulini ezine-leukemia engapheli ephathwa nge-agent eyodwa ibrutinib. UBr J Haematol. 2017; 178 (2): 286-291.

[8] UKamel S, uHorton L, uYsebaert L, et al. Ibrutinib ivimbela i-collagen-mediated kodwa hhayi ukuhlanganiswa kweplatelet kwe-ADP. Umdlavuza wegazi. 2015; 29 (4) 783-787.

[9] URigg RA, Aslan JE, Healy LD, et al. Ukuphathwa ngomlomo kweBruton's tyrosine kinase inhibitors kuphazamisa ukusebenza kweplatelet kwe-GPVI. NginguJ J Physiol Cell Physiol. 2016; 310 (5): C373-C380.

[10] UWang ML, Rule S, Martin P, et al. Ukuqondisa i-BTK nge-ibrutinib ku-mantle-cell lymphoma ebuyile noma ephikisayo. N Engl J Med. 2013; 369 (6): 507-516.

[11] UTron SP, uTripsas CK, uMeid K, et al. U-Ibrutinib ngaphambilini welapha i-macroglobulinemia kaWaldenström. N Engl J Med. 2015; 372 (15): 1430-1440.

[12] ULampson BL, Yu L, uGlynn RJ, et al. Ama-ventricular arrhythmias nokufa okungazelelwe ezigulini ezithatha ibrutinib. Igazi. 2017; 129 (18): 2581-2584.

[13] Tedeschi A, Frustaci AM, Mazzucchelli M, Cairoli R, Montillo M. Ngabe i-HBV prophylaxis iyadingeka ngesikhathi sokwelashwa kwe-CLL nge-ibrutinib? I-Leuk Lymphoma. 2017; 58 (12): 2966-2968.

[14] USun C, uTian X, uLee YS, et al. Ukuvuselelwa okuncane kokuzivikela komzimba kanye nokutheleleka okumbalwa kweziguli ezine-leukemia engapheli ephathwa nge-ibrutinib. Igazi. 2015; 126 (19): 2213-2219.

[15] URuchlemer R, uBen Ami R, uLakishi T. Ibrutinib we-leukemia engapheli ye-lymphocytic. N Engl J Med. 2016; 374 (16): 1593-1594.

[16] U-Ahn IE, Jerussi T, Farooqui M, Tian X, Wiestner A, Gea-Banacloche J. Atypical Pneumocystis jirovecii pneumonia ezigulini ebezingalashwa ngaphambilini ezine-CLL ku-ibrutinib yomenzeli oyedwa. Igazi. 2016; 128 (15): 1940-1943.

[17] UVitale C, Ahn IE, uSivina M, et al. I-autoimmune cytopenias ezigulini ezine-leukemia engapheli ephathwa nge-ibrutinib. I-Haematologica. 2016; 101 (6): e254-e258.

[18] I-Lip GY, iPan X, uKamble S, et al. Ingozi enkulu yokuphuma kwegazi phakathi kweziguli ze-non-valvular atrial fibrillation eziqale ku-apixaban, dabigatran, rivaroxaban powder noma i-warfarin: isifundo sokuhlola "umhlaba wangempela" e-United States. I-Int J Clin Pract. 2016; 70 (9): 752-763.

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