Amfani da Methotrexate don magance cututtukan zuciya na Psoriatic

Wadatacce

• Ta yaya methotrexate ke aiki azaman magani don cututtukan zuciya na psoriatic
• Amfanin methotrexate don cututtukan zuciya na psoriatic
• Sakamakon sakamako na methotrexate don cututtukan zuciya na psoriatic
• Ci gaban tayi
• Lalacewar hanta
• Sauran illolin
• Hadin magunguna
• Sashi na methotrexate wanda aka yi amfani dashi don cututtukan zuciya na psoriatic
• Sauran hanyoyi don maganin maganin maganin cututtukan zuciya na psoriatic
• Sauran DMARDs na al'ada
• Ilimin halittu
• Takeaway

Bayani

Methotrexate (MTX) magani ne wanda ake amfani dashi don magance cututtukan zuciya na psoriatic fiye da. Shi kadai ko a hade tare da sauran hanyoyin kwantar da hankali, ana daukar MTX a matsayin layin farko don magance matsakaiciyar cututtukan zuciya (PsA). A yau, yawanci ana amfani dashi a hade tare da sababbin magungunan ilimin halittu don PsA.

MTX yana da tasiri mai illa mai tsanani. A gefen ƙari, MTX:

• bashi da tsada
• yana taimakawa rage kumburi
• yana share alamun fata

Amma MTX baya hana lalata haɗin gwiwa lokacin amfani dashi shi kaɗai.

Tattauna tare da likitanka shin MTX kadai ko a haɗe tare da wasu magunguna na iya zama kyakkyawan magani a gare ku.

Ta yaya methotrexate ke aiki azaman magani don cututtukan zuciya na psoriatic

MTX magani ne na antimetabolite, wanda ke nufin cewa yana rikitar da aikin yau da kullun na sel, yana dakatar dasu daga rarraba. An kira shi magani mai canza cututtukan antirheumatic (DMARD) saboda yana rage kumburin haɗin gwiwa.

Amfani da shi na farko, wanda ya faro tun ƙarshen shekarun 1940, ya kasance cikin ƙwayoyi masu yawa don magance cutar sankarar bargo ta yara. A cikin ƙananan allurai, MTX na taƙaita tsarin garkuwar jiki kuma yana hana samar da ƙwayar lymphoid da ke cikin PsA.

MTX ta amince da Hukumar Abinci da Magunguna ta Amurka (FDA) a 1972 don amfani tare da psoriasis mai tsanani (wanda galibi yana da alaƙa da cututtukan zuciya na psoriatic), amma kuma ana amfani da shi sosai "kashe lakabin" don PsA. "Kashe lakabi" yana nufin likitanka na iya rubuta shi don cututtuka ban da wanda FDA ta amince da shi.

Ba a yi nazarin tasirin MTX don PsA ba a cikin manyan gwaje-gwajen asibiti, a cewar Cibiyar Nazarin Cutar Lafiyar Amurka (AAD). Madadin haka, shawarwarin AAD na MTX sun dogara ne akan ƙwarewar lokaci da sakamakon likitocin da suka tsara shi don PsA.

Wani labarin sake dubawa na 2016 ya nuna cewa babu wani binciken binciken bazuwar da ya nuna inganta haɗin MTX akan na placebo. Wani gwajin da aka yi na watanni shida na 2012 na mutane 221 a cikin watanni shida bai sami wata hujja ba cewa magani MTX kawai ya inganta kumburin haɗin gwiwa (synovitis) a cikin PsA.

Amma akwai ƙarin sakamako mai mahimmanci. Nazarin na 2012 ya gano cewa maganin MTX yi yana inganta ingantaccen ƙididdigar alamun cututtuka ta hanyar duka likitoci da mutane tare da PsA da ke cikin binciken. Hakanan, an inganta alamun fata tare da MTX.

Wani binciken, wanda aka ruwaito a cikin 2008, ya gano cewa idan mutanen da ke tare da PsA sun bi da su a farkon cutar a ƙara yawan MTX, suna da kyakkyawan sakamako. Daga cikin mutanen 59 a cikin binciken:

• Kashi 68 ya sami raguwar kashi 40 cikin ɗari a cikin ƙididdigar haɗin gwiwa
• Kashi 66 ya sami raguwar kashi 40 cikin ɗumbin kuɗaɗen haɗin gwiwa
• Kashi 57 cikin dari na da ingantaccen Yankin Psoriasis da Tsananin Lissafi (PASI)

Wannan bincike na 2008 an yi shi a asibitin Toronto inda binciken da ya gabata bai sami fa'ida ga maganin MTX ba don kumburin haɗin gwiwa.

Amfanin methotrexate don cututtukan zuciya na psoriatic

MTX tana aiki azaman anti-mai kumburi kuma yana iya zama mai amfani akan kansa don ƙananan lamuran PsA.

Nazarin 2015 ya gano cewa kashi 22 na mutanen da ke tare da PsA sun bi da MTX kawai sun sami aikin cutar kaɗan.

MTX na da tasiri wajen share shigar fata. Saboda wannan dalili, likitanka na iya fara maganin ka tare da MTX. Ba shi da tsada sosai fiye da sababbin magungunan ƙwayoyin cuta waɗanda aka haɓaka a farkon 2000s.

Amma MTX ba ya hana haɗin haɗin gwiwa a cikin PsA. Don haka idan kun kasance cikin haɗarin lalacewar ƙashi, likitanku na iya ƙarawa a ɗayan abubuwan ilimin halittu. Wadannan kwayoyi suna hana samar da sanadarin necrosis factor (TNF), wani abu mai haifar da kumburi a cikin jini.

Sakamakon sakamako na methotrexate don cututtukan zuciya na psoriatic

Illolin MTX na amfani ga mutane tare da PsA na iya zama mahimmanci. Anyi tunanin cewa kwayoyin halitta na iya a cikin halayen mutum zuwa MTX.

Ci gaban tayi

MTX sananne ne mai cutarwa ga ci gaban tayi. Idan kuna ƙoƙarin yin juna biyu, ko kuma idan kuna da juna biyu, tsaya a kan MTX.

Lalacewar hanta

Babban haɗarin shine cutar hanta. Kusan 1 cikin 200 da ke shan MTX suna da cutar hanta. Amma lalacewar tana sake juyawa lokacin da kuka tsayar da MTX. Dangane da Gidauniyar Psoriasis ta Kasa, haɗarin yana farawa ne bayan ka isa tarin rayuwarka na gram 1.5 na MTX.

Kwararka zai lura da aikin hanta yayin da kake shan MTX.

Rashin haɗarin lalacewar hanta yana ƙaruwa idan kun:

• sha barasa
• yi kiba
• da ciwon suga
• samun aikin koda mara kyau

Sauran illolin

Sauran illolin da ke tattare da illa ba su da mahimmanci, kawai ba dadi kuma yawanci ana iya sarrafa su. Wadannan sun hada da:

• tashin zuciya ko amai
• gajiya
• ciwon baki
• gudawa
• asarar gashi
• jiri
• ciwon kai
• jin sanyi
• haɗarin kamuwa da cuta
• hankali ga hasken rana
• jin zafi a cikin raunin fata

Hadin magunguna

Wasu magunguna masu ciwo irin su aspirin (Bufferin) ko ibuprofen (Advil) na iya ƙara tasirin MTX. Wasu maganin rigakafi na iya ma'amala don rage tasirin MTX ko yana iya cutarwa. Yi magana da likitanka game da magungunan ku da yiwuwar hulɗa tare da MTX.

Sashi na methotrexate wanda aka yi amfani dashi don cututtukan zuciya na psoriatic

Farawa na farawa na MTX don PsA shine 5 zuwa 10 milligram (MG) a kowane mako don makon farko ko biyu. Dogaro da amsarku, a hankali likita zai ƙara adadin don ya kai 15 zuwa 25 MG a mako, wanda aka ɗauka matsayin magani na yau da kullun.

Ana daukar MTX sau ɗaya a mako, ta baki ko ta allura. MTX na baka na iya zama a cikin kwaya ko sigar ruwa. Wasu mutane na iya rarraba kashi kashi uku a ranar da suka sha don taimakawa tare da sakamako masu illa.

Hakanan likitan ku na iya ba da umarnin ƙarin folic acid, saboda MTX sananne ne don rage matakan ƙoshin lafiya.

Sauran hanyoyi don maganin maganin maganin cututtukan zuciya na psoriatic

Akwai madadin magungunan magani don PsA ga mutanen da ba za su iya ko ba sa son ɗaukar MTX.

Idan kana da PsA mai sauƙin gaske, ƙila za ka iya sauƙaƙa alamomin tare da ƙwayoyin cuta masu saurin kumburi (NSAIDs) kadai. Amma NSAIDS tare da raunin fata. Hakanan abin yake game da allurar cikin gida na corticosteroids, wanda zai iya taimakawa da wasu alamun alamun.

Sauran DMARDs na al'ada

DMARD ta al'ada a cikin rukuni ɗaya kamar MTX sune:

• sulfasalazine (Azulfidine), wanda don inganta alamun cututtukan zuciya amma ba ya hana lalacewar haɗin gwiwa
• leflunomide (Arava), wanda zai inganta haɗin gwiwa da alamun fata
• cyclosporine (Neoral) da tacrolimus (Prograf), waɗanda ke aiki ta hanyar hana aikin calcineurin da aikin T-lymphocyte

Ana amfani da waɗannan DMARDS a wasu lokuta a haɗe tare da wasu magunguna.

Ilimin halittu

Akwai sabbin magunguna da yawa, amma waɗannan sun fi tsada. Bincike yana gudana, kuma da alama wataƙila za a sami wasu sababbin jiyya a nan gaba.

Ilimin halittu da ke hana TNF da rage lalacewar haɗin gwiwa a cikin PsA sun haɗa da waɗannan masu toshe alpha-TNF:

• karban bayanai (Enbrel)
• adalimumab (Humira)
• infliximab (Remicade)

Ilimin halittu masu rai wanda yake nufin sunadaran interleukin (cytokines) na iya rage kumburi da inganta sauran alamun. Waɗannan an yarda da FDA don magance PsA. Sun hada da:

• ustekinumab (Stelara), kwayar cutar monoclonal wacce ke niyya ga interleukin-12 da interleukin-23
• secukinamab (Cosentyx), wanda ke niyya da interleukin-17A

Wani zaɓin magani shine apremilast na miyagun ƙwayoyi (Otezla), wanda ke yin niyya akan ƙwayoyi a cikin ƙwayoyin garkuwar jiki waɗanda ke da alaƙa da kumburi. Yana dakatar da enzyme phosphodiesterase 4, ko PDE4. Apremilast yana rage kumburi da kumburin haɗin gwiwa.

Duk magungunan da ke kula da PsA suna da sakamako masu illa, don haka yana da mahimmanci a kimanta fa'idodi da illa tare da likitanka.

Takeaway

MTX na iya zama magani mai amfani ga PsA saboda yana rage kumburi kuma yana taimakawa bayyanar cututtuka gaba ɗaya. Hakanan yana iya haifar da mummunan sakamako, don haka kuna buƙatar sa ido akai-akai.

Idan fiye da ɗaya daga cikin gidajenku suna da hannu, haɗa MTX tare da DMARD mai nazarin halittu na iya zama da amfani wajen dakatar da lalata haɗin gwiwa. Tattauna duk hanyoyin maganin tare da likitanka, kuma sake nazarin shirin kulawa akai-akai. Wataƙila binciken da ke gudana cikin magungunan PsA zai zo nan gaba.

Hakanan zaka iya samun fa'ida don magana da "mai kula da haƙuri" a National Psoriasis Foundation, ko shiga ɗaya daga cikin ƙungiyoyin tattaunawa na psoriasis.