Treatment "sofosbuvir": wongororo. "Sofosbuvir" + "Daklatasvir": wongororo unyanzvi. "Sofosbuvir": kuraira vanachiremba wongororo

Chiropa rudzi rwekunatswa kwemuviri womunhu. Mamiriro emutumbi uyu ane simba pamagadziro emitemo yakawanda uye pauhu hwehupenyu hwomunhu pamwe chete. Chimwe chakanyanya kukuvadza kwechiropa ndicho hepatitis C. Nhasi, mishonga yakawanda yakagadzirirwa kurwisana nechirwere ichi. Imwe yenzira dzinoshanda zvikuru inofungidzirwa (iyo inopupurirwa nemashoko ekurapa), Sofosbuvir.

Zviratidzo zvekushandiswa

Muzhinji, cofactor inonzi inoshandiswa inoshandiswa mumapiritsi, uye icho pachayo ine zita rekutengesa "Sowaldi". Nokudaro, tinogona kutaura kuti mishonga iyi inoshandiswa mari inoshandiswa-inowanzoreva "Sofosbuvir", iyo inorondedzera inorondedzera mishonga seimwe yemishonga inoshanda zvikuru yekurapa chirwere chetachipatara C. Ichi ndicho chinzvimbo chikuru chekushandiswa.

Icho chinhu chikuru, sophosbuvir, inhibitor yeviral polymerase NS5B, kureva kuti, inoderedza nzira yekupararira kwehutachiona hweHepatitis C. Zvisinei, nyanzvi dzakawanda dzezvehutano hazvikurudzire Sofosbuvir monotherapy (kunyange izvi zvichinyatsooneka). Asi sechinhu chinonyanya kushandiswa chechidimbu chinorwarisa remishonga, chirwere che "Sofosbuvir" chinyorwa chinongova nehutano hwakanaka, kuchiratidza semushonga unobatsira zvikuru. Maererano neongororo dzechipatara, mishonga iri mumitambo nemimwe mishonga yakaratidza migumisiro yakanaka kwazvo maererano nekurapa kwehutachiona hweH hepatitis C (genotype 1, 2, 3).

Kurapa kweSofosbuvir nevashandi vehutano kunoratidzika zvakanaka kwete kwete chete nevarwere vasina kumbobatwa, asiwo kune avo vakambowana chirongwa chemishonga inorapwa nehumwe mishonga uye mushure mokurapa, mushure memakore ekudzoka zvakare.

Mukuwedzera kune zvakataurwa pamusoro apa zvinorondedzerwa, "Sofosbuvir" kuongororwa kwechiremba uye zvinorayira mirayiridzo zvinobvumira kushandiswa mune kurapa kwevarwere vane chirwere chepirhosis chechiropa.

Nekubudirira kwechirwere chekubatana kwehutachiwana neHIV uye hepatitis (iyo yakajairika mamiriro ezvinhu), ruzivo rwakadaro haruwanike, kunyange zvazvo mishonga inoratidzwa kuti ishandiswe mumamiriro ezvinhu akadaro.

Contraindications

Muhuwandu hwemhosva, mushonga wacho pachawo uye huwandu hwahwo hwakanga hwakanyatsorambidzwa nevarwere.

Zvisinei, mishonga yekurapa hepatitis C "Sovvaldi" (kana kuti "Sofosbuvir"), iyo maongorori akanaka, semhando ipi zvayo yemasikirwo inobudirira, ine zvimwe zvinopesana zvekushandiswa.

Kutanga, ihwo humwe hutachiona hwehutachiona hukuru uye humwe hutano hwechirwere. Vakadzi venguva yekubereka vanofanira kuchenjerera pavanenge vachishandisa. Kunyanya, kana "Sowaldi" ("Sofosbuvir") inorayirwa pamwe chete ne "Ribavirin" uye "Interferon alfa" (chaiyo ye genotype 3, 4, 5, 6, hepatitis), inofanira kunge iri munzira dzose dzingaita kuti urege kubata. Ichowo chisingadikanwi kupedza kurapwa nemishonga iyi panguva yekudzivirira uye panguva yekubata.

Parizvino, hapana ruzivo pamusoro pesimba reSofosbuvir pamabasa ekuberekwa kwevanhu. Panewo ruzivo pamusoro pekuchengetedza uye kubudirira kwechirwere muvarwere vasati vava nemakore gumi nemana.

Nzira uye nguva yekurapa

Kutanga, inofanirwa kurehwa kuti chirwere chinorapwa nehutachiona chinobvumirwa chete kune avo vashandi vezvokurapa vane ruzivo rwakakwana mukurapa varwere vane hepatitis C. R regimen yakazara ipiritsi imwe (400 mg yezvigadzirwa zvinoshandiswa) masikati panguva ipi zvayo yekudya. Sezvo mahwendefa ari anorwadza (aya ndiwo mhinduro kubva pamishonga yakagamuchira mishonga), "Sofosbuvir" inofanira kumedzwa pasina cheku uye kwete kuiputsa.

Kana iyo piritsi ikatorwa, uye shure kweiyo maawa maviri anotevera, kurutsa kwakatanga, zvinokurudzirwa kutora rimwe terefesi imwe. Kana kurutsa kunowedzera mushure mekunge kwenguva yakareba kupfuura maawa maviri, hapana chimwe chido chinodiwa.

Kana kuwedzera kwechirwere ichi nokuda kwechikonzero chipi nechipi chakanga chisisipo (nguva yekukurumidza isiri nguva inopfuura 18), zvinokurudzirwa kutora chirwere chisina kukwana, uye zvino ramba uchirapa panguva yakafanana. Kana kunonoka kudarika maawa gumi nemasere - tora chiitiko chinotevera panguva yakatarwa.

Nzira dzekubatanidza therapy

Sezvimwe zvikamu zvehutano hwakaoma hwekurapa hepatitis C, pamwe ne "Sofosbuvir", mutsika wekugadzwa kwe "Ribavirin", "Interferon alfa", "Daklatasvira", "Ladipasvira", "Asunaprevir".

Nenzira yakawanda, mutsara we "Sofosbuvir" + "Daklatasvir" kuongororwa kwevashandi vehutano nevarwere kunoratidzika seyakagadzirisa kurwisana nehepatitis C maitiro anokwana 1,2,3.

Kusvika iye zvino, "Daklataswir" inogona kurairwa paWWW.ARV24.COM webhusaiti nekutengeswa mumaoko - mune kambani ine ruremekedzo rurefu. Zvimwe kunze kwekuti maoko ane ruzivo rune ruzivo pamusoro pekuvapo kwechirwere.

Zvikamu 4, 5, 6 zvinobatwa nehutano hwemishonga "Sofosbuvir", "Ribavirin" uye "Interferon alfa". Muenzaniso wenguva yekurapa inguva masvondo gumi nemaviri. Mumamiriro ezvinhu apo varwere vane genotypes 1, 4, 5, 6 vanopesana nekutora Interferon alfa kana hypersensitivity kune ichi, Sofosbuvir neRibavirin inorayirwa kugamuchirwa kwemavhiki makumi maviri nemaviri.

Chirwere "Ribavirin" pamwe nemishonga "Sofosbuvir" ye 2 genotype kuongororwa kwezvenyanzvi uyewo inoratidza sekanaka rakanakisisa rinobatanidzwa, rinosarudzwa kuti ribvumirwe kwekanguva kwemavhiki gumi nemaviri. Mimwe mishonga miviri, asi kwekanguva yemasvondo makumi maviri nemasere, inoshandiswa ku 3 genotype ye viral hepatitis C.

Mashoko pamusoro pekubudirira kwehutano hwakakosha ne "Ribavirin" uye "Interferon" yekurapa genotype 1 haisipo.

Muchiitiko apo murwere anotambudzika ne hepatocarcinoma uye / kana anotarisira kushanda kwechiropa chekuisa, chiitiko che "Sofosbuvira" pamwe chete ne "Ribavirin" chinoshandiswa kwemavhiki makumi mana kana kuti kusvika kupindira kwekuvhiya kwechirwere chekugadzira. Izvi zvakakosha kuitira kudzivirira utachiona hwechiropa mushure mokunge tashandurwa.

Kuongorora kwechipatara kunoratidza kuti kushandiswa pamwe chete kweSofosbuvir nedzimwe mishonga kunogona kuita kuti nguva dzose zvirwere zve virologic zviitike mu 92% yezviitiko zvehutano hwakakomba mukurapa kwehutachiona hwehupatachi C.

Zvinokonzerwa nemigumisiro

Muchiitiko chekuita mishonga yekliniki, mushonga wacho wakanyatsorambidzwa zvikuru nevarwere (zvakadai zvaiva mhinduro dzavo). "Sofosbuvir" inokonzera migumisiro mune dzimwe nguva apo inoshandiswa pamwe chete ne "Ribavirin" uye "Interferon".

Paunobatanidza Sofosbuvira neRibavirin, kuwedzera kwehemoglobin kunoderedza kuumbwa kweropa kakawanda (zvinopfuura 10% zvezviitiko) uye mazinga ebilirubin anowedzera, kuneta, kusagadzikana uye kusuruvara, kusuruvara kunogona kuitika.

Pashoma nguva zhinji (pasi pe10% yezviitiko), kusanganiswa kwezvinodhaka kunokonzera kushungurudzika, anemia, rhinopharyngitis, kucherechedza chirwere chepfungwa, dyspepsia, kuvimbiswa uye kuvhiringidzika kwepamuviri, kuratidzwa kwezvirwere paganda (itching, rashes). Dzimwe nguva varwere vanosiya mashoko akadai: "Sofosbuvir", yakashandiswa zvakafanana ne "Ribavirin", yakaratidza kusuruvara kwevhudzi uye kurwadziwa shure, kukanganisa, myalgia uye asthenia.

Kana zvakakosha zvemishonga mitatu ishandiswa ("Interferon alfa" inowanikwa kune iri pamusoro apa inotaurwa), mutsara wakawandisa wezviitiko zvinotambudza kazhinji (zvinopfuura 10% zvezviitiko). Pano vanotaura pamusoro pekushandura mukugadzirwa kweropa: kuderera kwehuwandu hwemaitiro e-lymphocytes, platelets uye neutrophils, anemia, kuwedzera kwezinga re bilirubin. Kubva kune chikamu chekudya kunogona kukurudzira chirwere, kusuruvara, kurutsa. Mukuwedzera, Sofosbuvir (mirayiridzo, kuongororwa kwevarwere uye vashandi vehutano vanosimbisa) kunogona kukonzera misoro uye chizuru, kukwezva, kuperevedza kufema, kubvarura uye kukurumidza, myalgia uye kurwadziwa pamwe chete. Kazhinji varwere vanotaura nezvekuneta, kusagadzikana, chills, fever.

Pasi pfupi (kubva pa1 kusvika ku10%) varwere vanotaura nezvekutya nekukudzika kwekuora mwoyo, nezvekurasika kwemazivi, pamusoro pekuyeuka nekufungisisa kusakanganisika, pamusoro pemigraines. Iko kune ruzivo pamusoro pokuderera kwemaonero, kusuruvara kwevhudzi, kukura kwe reflux uye dyspnea uye kuwedzerwa mutoro. Dzimwe nguva varwere vanotaurirana nezvekutambudzika mukati nepamusoro nepfupa, kusuruvara uye asthenia.

Chii chandinofanira kuziva?

Kana murwere ane chimwe chinhu kana zvimwe zvisingaiti - pakutanga kuwanda kwehutachiona hwehutachiona, progressive fibrosis, ganda rakasviba, saka kurapwa kweSofosbuvir (nyanzvi dzeongororo nemirayiridzo yekushandiswa inogutsa) inogona kuwedzerwa kusvika masvondo makumi maviri nemana. Kana chirwere chinosanganiswa chinoshandiswa, chirwere chinoshanda che "Ribavirin" chinosarudzwa maererano nehutano hwehutano hwemurwere, kureva kuti 75 kg yehutemi hwemuviri inoda 1.2 g yemishonga. Iyo yose yehutachiona yakakamurwa kuita zvikamu zviviri uye inotorwa nechingwa.

Hazvikurudzirwi kuderedza kuyerwa kwe "Sofosbuvira".

Kana kubatana kweSolfosbuvir neInterferon alfa kukudziridza kuratidzira kusina kunaka kwechirwere chekupedzisira, iyo inotorwa inonzi Interferon inoda kuderedza kana kubvisa zvachose mishonga (tsanangudzo yakazara pamusoro pekudzikisa kana kuregererwa kwemishonga inowanika mumirayiridzo inokosha).

Ndizvo zvakafanana apo kuwirirana kwe "Sofosbuvira" ne "Ribavirin" kunoshandiswa, uye migumisiro yakaipa inokura paigamuchirwa chekupedzisira - chido chacho chinoderera kana kugamuchirwa kwe "Ribavirin" kunopera zvachose. Pashure pemigumisiro yeropa rekuvandudza, zvinotenderwa kuedza zvakare kutora Ribavirin, kubva pa 600 mg uye zvishoma nezvishoma kuwedzera kusvika 800 mg. Hazvikurudzirwi kuwedzera chiremba kusvika kune yakatanga kupiwa mazai.

Kana iwe ukarasa rimwe remishonga inorapwa yakaoma, iwe unofanirwa kurega kutora "Sofosbuvir" zvachose - mazano evadzidzisi uye mirayiridzo yekushandisa munyaya iyi yakafanana.

Kuwirirana nezvimwe zvinhu

Vashandi vezvokurapa havatauri varwere nenzira yakafanana nemishonga iri mubvunzo kuti vasashandise mamwe maitiro antiviral (kunze kweavo vanorayirwa nechiremba anoenda) munguva iyo hepatitis inobatwa. "Sofosbuvir" inongororwa nenyanzvi inofunga kuti inogona kuwirirana nechimwe chinhu mune izvo zviitiko apo zvinotarisirwa kubatsirwa nekubatanidzwa kwezvinodhaka zvinodarika zvinogona kuitika zvekusafarirwa.

Kunewo mapoka ezvinodhaka, kushandiswa pamwe chete uko neSofosbuvir inogona kuderedza zvakanyanya kukohwa kwayo ("Sofosbuvira") mumatumbo. Kumishonga yakadaro - kubva kune anticonvulsants - inogona kutakura "Phenytoin", "Phenobarbital", "Carbamazepine" uye "Oxcarbazepine". Bhuku reAntimycobacterial yemishonga inewo mishonga yakadai: Rifabutin, Rifampicin, Rifapentin. Pamusoro pemishonga inowedzera, kubatwa kweSofosbuvir kunogona kuderedza zvakanyanya kudyiwa kwaSt John's wort. Izvo hazvikurudzirwi kuyananisa mushonga pamwe neHIV protease inhibitors: "Tipranavir", "Ritonavir".

Special instructions

Chero chiremba anoenda kune kodzero yekusarudza chirongwa cherapa ye hepatitis C nemishonga inenge yakanyorerwa kurapwa: "Ladipasvir", "Asunaprevir", "Sofosbuvir", "Daklatasvir". Kuongororwa kwevarwere kwevatungamiri vose ve "Sovvaldi" vakanaka.

Zvisinei, inofanira kutarisirwa mupfungwa kuti kune varwere vane maitiro akakomba ekukundikana kwechirwere, kukosha kwechiremba kunofanira kusarudzwa zvakananga. Izvo hazvina chikonzero chekudzokorora madhagi kune avo vanorwara nehupenzi uye huwandu hwehutano. Kana iri kushaya simba, haifaniri kuchinja muroti kuvarwere vane dambudziko ripi zvaro rechirwere.

Mukurapa kwehepatitis C nekushandiswa kwemaawa ekubatanidza pamusana pe "Sofosbuvira" hazvibvumirwi kuita zvinhu izvo zvinoda kuisa pfungwa yekufungisisa nekukurumidza kwekupindura kwepfungwa.

Price range

Mutengo wemishonga inonzi maGermany muGermany inowanikwa kubva pa18 kusvika ku20 000 euro. Uye kuti uzvitenge, kunyange pamutengo uyu, iwe unoda mushonga kubva kuchiremba kurapa. Mari yakakosha yakadaro inokonzerwa nekuti kambani yekugadzira zvinhu inofanira kubhadhara zvose zvayo mari yekutsvakurudza kwesayenzi, kubudirira uye kuongororwa kwemishonga.

Zvinodhura zvakanyanya kutengesa mishonga yemagetsi (zvinodhura zvinyorwa zvechigadzirwa nechinhu chakafanana chinoshanda). Izvi zvinosanganisira "Daklatasvir", "Asunaprevir", "Ladipasvir" uye "Sofosbuvir". Vavengi vezvekuongorora vanosanganisira mashoko pamusoro pemari yakakura yemishonga iyi, asi haisi ye makumi ezviuru ema euro.

Kutanga muna March 2015, maererano neisense yekambani yekugadzira, kusunungurwa kweSofosbuvira kwakatanga nekambani yeIndia yemishonga Natko (zvakasununguka, nemvumo yeUnited Health of India).

Parizvino, muRussia zvinonyatsobvira kutenga mapepa (mapiritsi makumi maviri nemakumi mana) emishonga "Sofosbuvir" pamutengo we 39 900 rubles (1 piritsi imwe ichasvika anenge 1800 rubles). Izvi hazvibatsiri, asi zvakanyatsozivikanwa zvakaiswa "Sowaldi" zvinoda mari yekutsvaga mari mumutengo we 1,500,000 rubles, iyo inenge inodarika makumi matatu inopfuura inodhura kudarika chero inogadzirwa.

Nokushandisa mishonga yemaketani, hapana nzira yokutenga mishonga iyi, kubva pakugadziriswa kwemishonga mitsva muRussia yakakura kwenguva refu.

Pfungwa dzevatengi uye vanachiremba

Mushonga wacho wakatorwa nevarwere vane hepatitis vari genotypes dzakasiyana, mararamiro akasiyana-siyana e fibrosis, ane transaminase akareba zvikuru kupfuura ose akaenzana uye, sekutonga, kuwanda kwehutachiona hwehutachiona.

Iyo yakawanda kwazvo yevarwere vachitora mishonga ichi kusiya zvakanaka maonero pamusoro pemishonga yeSofosbuvir. Ndiani akabatwa (kuongororwa kazhinji ane mashoko akadaro) kare kubva kune hepatitis C interferons, inoratidza kuti mishonga haigoni kuenzaniswa. Interferons inokonzera migumisiro yakawanda, uye havasi varwere vose vane simba rakakwana rokutakura. Nekubatanidzwa kweSofosbuvir neDadlatasvir (varwere vakawanda vanotaura nezvemhando yakadaro), chete chikamu chiduku chevaya vanobatwa nemishonga iyi vakataura nezvekugadzirwa kwezvinhu zvisingabatsiri muhutano hwechezuru, kunyorova musoro uye kupera kwenguva shoma yekubatanidza. Zvisinei, zviratidzo izvi hazvigoni kuenzaniswa nemigumisiro yeAlferon uye nemigumisiro yehepatitis pachayo. Mushure memasvondo matatu ekurapa, zvinyorwa zve transaminases muropa zvinowanzoitika kune varwere vakawanda. Sezvo vhiki yechitatu yekurapa nehutachiona hwemishonga yemishonga inonzi "Sofosbuvir" uye "Daklatasvir" kune varwere vakawanda, chikonzero chekuvapo kwehutachiona hweHepatitis mu mumuviri hauna kunaka.

Uyewo, varwere vazhinji vanorondedzera kuderedza kuderedzwa kwe fibrosis mushure memwedzi yakawanda yekurapa kwakanyanya.

Vashandi ivavo vakatora mishonga yemishonga mitatu - Sofosbuvir, Daklatasvir, uye Ribaverine - zvakare vakafara zvikuru nemigumisiro yekurapa.

Vanenge vose vatengi veSofosbuvir vachitaura nezvekubudirira kwechokwadi mukurapa kwehutachiona hepatitis C zvichienzanisa ne interferon therapy. Zvakanatsiridza hutano hwakanaka uye hutano hwehupenyu hwevarwere - ihwohwo uchapupu hwakananga.