Ruo n'oge na-adịbeghị anya, ọtụtụ ndị dọkịta na-ekwu banyere nkwupụta cholesterol-diet-CHD. Nke mbụ, ọkwa cholesterol dị elu na ọbara ma ọ bụ hypercholesterolemia na-akpata ọrịa obi na- akpata ọrịa obi (CHD). Nke abụọ, nri ndị bara ọgaranya na abụba anụ na cholesterol na-amụba ọkwa cholesterol n'ime ọbara. Nke atọ, ịkụda ọkwa cholesterol n'ime ọbara na-ebelata ihe ize ndụ maka ọrịa obi na-arịa ọrịa obi.
N'ihe bara uru, nkwenye cholesterol-diet-CHD na-egosi na ọ bụ ezi uche. E kwuwerị, "anyị bụ ihe anyị na-eri," ọ bụrụ na anyị eri nri bara ọgaranya na cholesterol na abụba (anụ), mgbe ahụ, ọbara cholesterol ọbara anyị ga-arịgo elu. Ọzọkwa, ebe ọ bụ na ihe nkedo-nke na-arịa ọnyá na-eme ka CHD na ọrịa strok-bụ akụkụ cholesterol, ọtụtụ ọkwa cholesterol dị na nri ọbara ga-eme ka ohere maka CHD na ọrịa strok dịkwuo elu. Na, ọ bụrụ na ị ga-agbadata ọkwa cholesterol n'ọbara gị site na iji ọgwụ, mgbe ahụ, ị belata ohere ị nwere maka CHD na strok, nri? Ọfọn, n'ihe gbasara echiche ndị a nile, o yighị.
N'oge na-adịbeghị anya, oké osimiri gbanwere na ụkpụrụ ndị na-achịkwa nlekọta nke CHD. Anyị ejighị n'aka na ihe oriri bara ọgaranya na cholesterol na abụba jupụtara na-akpata kpọmkwem ụba cholesterol n'ọbara. Ọzọkwa, anyị ejighị n'aka ma ọ bụrụ na ịdalata ọbara cholesterol n'ọbara ndị nọ n'ihe ize ndụ maka ọrịa obi na-enye aka gbochie strok, angina na-adịghị ike, obi mgbawa na ihe ndị ọzọ.
Ihe niile anyị maara bụ na mgbanwe ndụ (dịka ọmụmaatụ, ọnwụ nha, mmega ahụ na ịṅụ sịga) yana statins, ma ọ bụ ọgwụ ọjọọ dị ka Zocor na Crestor, nke na-eme ka ihe ncheta dị elu ma mee ka obere lipoprotein cholesterol (LDL-C) "cholesterol" ọjọọ ", nwere ike inye aka igbochi ọnwụ na nsogbu ndị ọzọ na-adịghị mma,
Evolocumab sitere na ọgwụ ọhụrụ. N'ọnwụnwa ahụike a egosiwo ya ngwa ngwa ịgụta ọnụ ọgụgụ LDL-C n'ọtụtụ ndị nọ na ya-karịsịa ndị na-arịa ọrịa mkpụrụ ndụ nke a na-akpọ hypercholesterolemia ezinụlọ nke na-ebute ọkwa cholesterol (n'ezie, dị elu) na ọbara. Ugbu a ma ọ bụrụ na evolocumab ga-enye uru ọ bụla n'ime ọtụtụ ndị nọ n'ihe ize ndụ maka ọnwụ na ihe ọjọọ ndị ọrịa ọrịa obi na-akpata na-anọgide na-ahụ, ma eleghị anya na-adabere na nsonaazụ nke ogologo oge ma ọ bụ ihe ịga nke ọma nke ga-eme ka ndị nabatara n'oge evolocumab (Repatha ) ọgwụgwọ. N'okwu ndị ọzọ, naanị oge ga-agwa ma arụ ọrụ evolocumab.
Kedu ihe bụ Evolocumab?
Evolocumab bụ mgbochi monoclonal zuru oke mmadụ nke na-ejikọta ya ma si otú a gbochie protein PCSK9. Ntinye a na-emetụta onye nabatara LDL-C maka imebi site na imeju ya ma na-egbochi ikike nke onye nzaghachi a iji regharịa. (N'ụzọ dị mma, nchọpụta na-egosi na statins nwere ike ime ka PCSK9 gbanwee, ma, mgbe ejiri ya mee ihe, statins na evolocumab adịghị kpọmkwem synergize ma ọ bụ nwere ike.)
Ugbu a, Amgen, onye na-eme ihe evolocumab, na-eduzi ọtụtụ ule dịgasị iche iche na-agwọ ọrịa na ọtụtụ ndị ọrịa na gburugburu ụwa.
Nsonaazụ nke ule ndị a na-ekwe nkwa maka ikike evolocumab nwere ịkụda ọkwa LDL-C. Dịka ọmụmaatụ, na otu ule nke atọ nke ikpe, ndị na-eso ndị ọrịa hyperklesterolemia (homozygous familial hypercholesterolemia) bụ ndị nọ na usoro ọgwụgwọ (ụfọdụ ndị nọ na ọgwụ cholesterol ọzọ a na-akpọ Zetia) nwetara pasent 31 na LDL-C ọkwa na 12 izu ole na ole na-atụle ndị na-anabataghị ọgwụ. (Ndị na-eso ha enwekwara pasent 23 na apolipoprotein B.) Nke kachasị njọ, evolocumab na-arụ ọrụ ngwa ngwa karịa ọgwụ ndị ọzọ ọ bụla ọzọ na-agbadata ala ahụ: lomitapide na mipomersen.
Iji buo, na mmebi mmetụta, evolocumab ka mma karịa lomitapide na mipomersen.
N'akụkụ nke atọ nke 3, ndị na-anabataghị ma ọ dịkarịa ala abụọ statins ma mesoo naanị evolocumab na Zetia hụrụ ọnụ ọgụgụ 53 ruo 56 na LDL-C ma e jiri ya tụnyere 37 ruo 39 percent belata na ndị na-anabata Zetia naanị. Ọzọkwa, evolocumab mere ka ihe dị egwu karịa Zetia.
N'ikpeazụ, na nchọpụta nke abụọ nke abụọ, na ndị na-eso hypercholesterolemia na ndị na-ajụ ya-na-esi ike na-arịwanye elu, evolocumab belata LDL-C site na pasent 66 ruo pasent 75 mgbe a na-eme ya ugboro abụọ n'ọnwa.
Ọ Pụrụ Inyere Ndị Ọrịa Aka?
N'ebe a, ndị juri ahụ ka na-achọpụta ma evolocumab ga-enwe ike ịnye uru ahụike ọ bụla n'ime ndị nwere ihe ize ndụ maka ịrịa ọrịa strok na nkụchi obi. Nanị ịdọrọ ọkwa cholesterol nwere ike ịpụta obere ihe n'ọtụtụ mmadụ, isi ihe ọhụrụ ACC / AHA weghaara ebe obibi, bụ nke kpochapụla ihe dị iche iche "cholesterol" ọbara. Ọzọkwa, ụkpụrụ nduzi ndị a na-egosi na mkpụrụ ndụ, nanị ọgwụ ndị na - egosi uru ọ bụla na mbenata ọrịa obi na ọrịa, kwesịrị ka e mee ka ndị mmadụ nwee ọrịa obi (ọrịa strok ma ọ bụ nkụchi obi), ndị LDL-C na-enwe karịa 190 ( cholesterol dị njọ "dị njọ"), ndị dị afọ 40 ruo 75 nke nwere ọrịa shuga 2, na ndị dị afọ 40 ruo 75 na-enwe ọnụọgụ ọrịa nke pasent 7.5 nke ọrịa obi n'afọ iri na-esonụ.
Ọ bụrụ na ọ bụrụ na ị na-esonyere ndị na-eso ụzọ ruo ọtụtụ afọ, evolocumab na-eme ka ọ dị mma na mwepụ ọrịa ọrịa obi dị ka ọrịa strok na nkụchi obi, mgbe ahụ, anyị na-ele anya na ọganihu ọgwụ nwere ike iji ya tụnyere statins. Anyị na-echekwa okwu nkwenye cholesterol-diet-CHD bụ nke egosipụtara na ọ gaghị adabere n'ọtụtụ afọ nyochaa sayensị. N'ikpeazụ, ike evolocumab nwere ike iwepụ ala LDL-C n'ụzọ dịgasị iche iche dị iche iche na-echetara Zasty, bụ nke na-egbochi ndị na-ebu agha, bụ nke gosipụtara na ọ gaghị adị irè (ma ọ bụ ọbụna dịtụ njọ) na-egbochi nrụpụta akara ngosi na ndị na-amụ ihe. N'ikwu ya n'ụzọ ọzọ, Zetia bụ ihe a na-atụghị anya ya, ya mere ọ ga-abụ evolocumab
> Isi mmalite
> "Anti-PCSK9 Mgbochi nke Ọma Dara Cholesterol na Ndị Ọrịa na Statin Intolerance" site n'aka Erik Stroes na ndị ọrụ ibe ya bipụtara na 11/23/2014 (e-pub n'ihu mbipụta) na Journal of the American College of Cardiology.
> Bersot TP. Isi nke 31. Ọgwụ Drug maka Hypercholesterolemia na Dyslipidemia. Na: Brunton LL, Chabner BA, Knollmann BC. eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e . New York, NY: McGraw-Hill; 2011.
> "Mmetụta nke evolocumab ma ọ bụ ezetimibe gbakwunyere na-eme ka usoro ọgwụgwọ na LDL-C na-arịwanye elu na ndị ọrịa nwere hypercholesterolemia: usoro ikpe ụlọ ọgwụ LAPLACE-2" nke JG Robinson na ndị ọrụ ibe ya bipụtara na JAMA na 5/14/2014.
> "Mgbochi nke PCSK9 na evolocumab na homozygous ezinụlọ hypercholesterolemia (TESLA Nkebi B): usoro ikperede, abụọ-bline, ikpe ikpe maka placebo" nke FJ Raal na ndị ọrụ ibe ya bipụtara na Lancet na 10/2/2014.