Bincike na Nan gaba da Gwajin Gwajin Ci Gaban Firamare na MS

Wadatacce

• Bayani
• Nau'in MS
• Fahimtar MS mai ci gaba
• PPMS jiyya
• Distance Ga-Rankuwa-Ocrevus (Ocrelizumab)
• Gwaje-gwajen asibiti na PPMS da ke gudana
• NurOwn kara cell far
• Biotin
• Masitinib
• Kammala gwaji na asibiti
• Ibudilast
• Idebenone
• Laquinimod
• Fampridine
• Binciken PPMS
• Takeaway

Bayani

Magungunan sclerosis (MS) wani yanayi ne na rashin lafiyar autoimmune. Yana faruwa ne lokacin da jiki ya fara kai farmaki kan sassan tsarin juyayi na tsakiya (CNS).

Yawancin magunguna da jiyya na yanzu suna mai da hankali ne akan sake dawowar MS kuma ba akan MS mai ci gaba ba (PPMS). Koyaya, ana gudanar da gwaji na asibiti koyaushe don taimakawa ƙarin fahimtar PPMS da kuma samo sabbin magunguna masu inganci.

Nau'in MS

Manyan nau'ikan MS guda hudu sune:

• cututtukan cututtuka na asibiti (CIS)
• sake dawo da MS (RRMS)
• MS na ci gaba na farko (PPMS)
• MS na gaba na gaba (SPMS)

Waɗannan nau'ikan MS an ƙirƙire su don taimakawa masu binciken likita su rarrabe mahalarta gwajin gwaji tare da ci gaban cutar. Wadannan rukuni suna bawa masu bincike damar kimanta inganci da amincin wasu jiyya ba tare da amfani da adadi mai yawa na mahalarta ba.

Fahimtar MS mai ci gaba

Kashi 15 cikin ɗari ko ɗari na duk mutanen da suka kamu da cutar ta MS suna da cutar PPMS. PPMS yana shafar maza da mata daidai, yayin da RRMS ya fi dacewa ga mata fiye da na maza.

Yawancin nau'ikan MS suna faruwa ne lokacin da tsarin rigakafi ya afka kan ɗakunan myelin. Kullun myelin abu ne mai mai, mai kariya wanda ke kewaye jijiyoyi a cikin laka da kwakwalwa. Lokacin da aka afka wa wannan abu, yana haifar da kumburi.

PPMS yana haifar da lalacewar jijiyoyi da tabo a wuraren da aka lalata. Cutar ta rikitar da tsarin sadarwar jijiyoyi, yana haifar da tsarin da ba za a iya hango shi ba game da alamomin cutar da ci gaban cuta.

Ba kamar mutanen da ke da RRMS ba, mutanen da ke da PPMS suna fuskantar mummunan aiki a hankali ba tare da sake komowa da wuri ba. Baya ga karuwar rashin ƙarfi a hankali, mutane masu cutar PPMS na iya fuskantar waɗannan alamun alamun:

• wani abin mamaki na dushewa ko kaɗawa
• gajiya
• matsala tare da tafiya ko tare da daidaitawar ƙungiyoyi
• batutuwa tare da hangen nesa, kamar hangen nesa biyu
• matsaloli tare da ƙwaƙwalwar ajiya da ilmantarwa
• jijiyoyin tsoka ko taurin kafa
• canje-canje a cikin yanayi

PPMS jiyya

Yin jinyar PPMS ya fi wuya fiye da magance RRMS, kuma ya haɗa da yin amfani da hanyoyin kwantar da hankali na rigakafi. Waɗannan hanyoyin kwantar da hankali suna ba da taimako na ɗan lokaci kawai. Ba za a iya amfani da su cikin aminci da ɗorewa ba na foran watanni zuwa shekara ɗaya a lokaci ɗaya.

Yayinda Hukumar Abinci da Magunguna (FDA) ta amince da magunguna da yawa don RRMS, ba duka sun dace da ci gaban nau'ikan MS ba. Magungunan RRMS, waɗanda aka fi sani da ƙwayoyi masu canza cuta (DMDs), ana shan su gaba ɗaya kuma galibi suna da tasirin illa mara haƙuri.

Hakanan za'a iya samun raunuka masu lalacewa da lalacewar jijiya a cikin mutanen da ke da PPMS. Raunukan suna da kumburi sosai kuma suna iya haifar da lahani ga ƙyallen myelin. A halin yanzu ba a san ko magungunan da ke rage kumburi na iya rage nau'ikan ci gaban MS.

Distance Ga-Rankuwa-Ocrevus (Ocrelizumab)

FDA ta amince da Ocrevus (ocrelizumab) a matsayin magani ga duka RRMS da PPMS a watan Maris na 2017. Har zuwa yau, ita ce kadai magani da aka yarda da FDA ta bi da PPMS.

Gwajin gwaji na asibiti ya nuna cewa ya sami damar rage ci gaban bayyanar cututtuka a cikin PPMS da kusan kashi 25 idan aka kwatanta da placebo.

Ocrevus kuma an yarda dashi don maganin RRMS da "farkon" PPMS a Ingila. Ba a riga an amince da shi ba a wasu yankuna na Kingdomasar Ingila.

Cibiyar Nazarin Kiwon Lafiya ta Kasa (NICE) da farko ta ki amincewa da Ocrevus bisa dalilin cewa kudin samar da shi ya zarta amfaninsa. Koyaya, NICE, Hukumar Kiwon Lafiya ta Kasa (NHS), da mai kera magunguna (Roche) daga ƙarshe sun sake tattaunawa kan farashinsa.

Gwaje-gwajen asibiti na PPMS da ke gudana

Babban mahimmin mahimmanci ga masu bincike shine ƙarin koyo game da siffofin MS na ci gaba. Sabbin magunguna dole ne suyi ta cikin gwaji na asibiti mai tsanani kafin FDA ta amince dasu.

Yawancin gwajin asibiti na ƙarshe na shekaru 2 zuwa 3. Koyaya, saboda binciken yana iyakance, har ma ana buƙatar tsawan gwaji don PPMS. Ana gudanar da ƙarin gwaji na RRMS saboda yana da sauƙi don yanke hukunci kan ingancin magani kan sake komowa.

Duba Multiungiyar Sadarwar leasa ta Jama'a don cikakken jerin gwajin asibiti a Amurka.

Wadannan zaɓaɓɓun zaɓuɓɓuka suna gudana a halin yanzu.

NurOwn kara cell far

Brainstorm Cell Therapeutics yana yin gwajin gwaji na zamani na II don bincika aminci da tasirin kwayar NurOwn wajen kula da ci gaban MS. Wannan magani yana amfani da ƙwayoyin sel wanda aka samo daga mahalarta waɗanda aka zuga don samar da takamaiman abubuwan haɓaka.

A watan Nuwamba na 2019, Multiungiyar Nationalungiyar Nationalwararrun lewararrun lewararrun Nationalwararru ta awardedasa ta ba da kyautar Brainstorm Cell Therapeutics a $ 495,330 tallafin bincike don tallafawa wannan maganin.

Ana sa ran kammala shari'ar a watan Satumba na shekarar 2020.

Biotin

MedDay Pharmaceuticals SA a halin yanzu tana yin gwaji na asibiti na lokaci na III akan tasirin kwayar maganin biotin mai ƙarfi don kula da mutane tare da MS mai ci gaba. Har ila yau, fitinar na nufin mayar da hankali ga mutanen da ke da matsala.

Biotin wani bitamin ne wanda ke tattare da tasirin tasirin haɓakar salula gami da samar da myelin. Ana kwatanta kwalin biotin da placebo.

Shari'ar ba ta daukar sabbin mahalarta, amma ba a tsammanin kammalawa har zuwa Yuni 2023.

Masitinib

Kimiyyar Kimiyyar Kimiyyar Kimiyyar Kimiyyar Kimiyyar Kimiyyar Kimiyyar kere-kere na gudanar da gwaji na uku a kan magungunan masitinib. Masitinib magani ne wanda ke toshe amsar kumburi. Wannan yana haifar da ƙananan amsar rigakafi da ƙananan matakan kumburi.

Gwajin yana tantance aminci da tasirin masitinib idan aka kwatanta da placebo. Ana kwatanta tsarin kulawa na masitinib guda biyu zuwa placebo: Tsarin farko yana amfani da wannan sashi a ko'ina, yayin da ɗayan ya ƙunshi haɓaka sashi bayan watanni 3.

Shari'ar ba ta daukar sabbin mahalarta. Ana tsammanin kammala shi a watan Satumba na 2020.

Kammala gwaji na asibiti

Wadannan gwaje-gwajen da aka biyo baya an kammala su. Ga yawancinsu, an buga sakamakon farko ko na ƙarshe.

Ibudilast

MediciNova ya kammala gwajin gwajin lokaci na II akan maganin ibudilast. Manufarta ita ce ta ƙayyade lafiyar da aikin ƙwayoyi a cikin mutanen da ke da ci gaba na MS. A cikin wannan binciken, ibudilast an kwatanta shi da placebo.

Sakamakon binciken farko ya nuna cewa ibudilast ya jinkirta ci gaban ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa idan aka kwatanta da placebo a cikin tsawon makonni 96. Abubuwan da aka fi sani da illa na yau da kullun sune alamun cututtukan ciki.

Kodayake sakamako yana da tabbaci, ana buƙatar ƙarin gwaji don ganin idan sakamakon wannan fitinar za a iya sake bugawa da yadda ibudilast zai iya kwatantawa da Ocrevus da sauran magunguna.

Idebenone

Cibiyar Kiwon Lafiyar Jama'a da Cututtuka (NIAID) kwanan nan ta kammala wani gwaji na I / II na asibiti don kimanta tasirin idebenone ga mutanen da ke da PPMS. Idebenone sigar roba ce ta coenzyme Q10. An yi imanin iyakance lalacewa ga tsarin mai juyayi.

A cikin tsawon shekaru 2 na ƙarshe na wannan gwajin na shekaru 3, mahalarta sun ɗauki ƙwayoyi ko wani wuribo. Sakamakon farko ya nuna cewa, yayin karatun, idebenone bai ba da fa'ida a kan wurin ba.

Laquinimod

Teva Pharmaceutical Industries ta dauki nauyin karatun karo na II a kokarin kafa hujja game da maganin PPMS tare da laquinimod.

Ba a cika fahimtar yadda laquinimod yake aiki ba. An yi imani da canza halayen ƙwayoyin ƙwayoyin cuta, saboda haka hana lalacewar tsarin jijiyoyi.

Sakamakon fitina ya haifar da masana'anta, Active Biotech, don dakatar da ci gaban laquinimod a matsayin magani ga MS.

Fampridine

A cikin 2018, Kwalejin Jami'ar Dublin ta kammala wani gwaji na zamani na IV don bincika tasirin fampridine a cikin mutanen da ke fama da matsalar ƙarancin hannu da kuma PPMS ko SPMS. Fampridine kuma ana kiranta da suna dalfampridine.

Kodayake an kammala wannan gwajin, ba a bayar da rahoton sakamako ba.

Koyaya, bisa ga nazarin Italia na 2019, miyagun ƙwayoyi na iya haɓaka saurin sarrafa bayanai a cikin mutane tare da MS. Binciken 2019 da zane-zane ya ƙaddara cewa akwai tabbaci mai ƙarfi cewa ƙwayoyi sun inganta ikon mutane da MS don yin tafiya kaɗan kaɗan da ƙwarewar tafiyarsu.

Binciken PPMS

Multiungiyar Multiungiyar Sclerosis ta Nationalasa ta isasa tana haɓaka bincike mai gudana cikin nau'ikan ci gaba na MS. Manufar ita ce ƙirƙirar jiyya masu nasara.

Wasu bincike sun mai da hankali kan banbanci tsakanin mutane masu cutar PPMS da lafiyayyun mutane. Wani binciken da aka gudanar ya gano cewa kwayoyin halittar cikin kwakwalwar mutanen da ke dauke da cutar PPMS sun fi tsofaffin kwayoyin halittar guda daya a cikin masu lafiya irin wannan shekarun.

Bugu da ƙari, masu binciken sun gano cewa lokacin da oligodendrocytes, ƙwayoyin da ke samar da myelin, aka fallasa su ga waɗannan ƙwayoyin sel, sun bayyana sunadarai daban-daban fiye da na masu lafiya. Lokacin da aka toshe wannan bayanin na furotin, oligodendrocytes yayi al'ada. Wannan na iya taimakawa wajen bayyana dalilin da yasa myelin ke cikin damuwa a cikin mutane masu cutar PPMS.

Wani binciken ya gano cewa mutanen da ke fama da cutar ta MS suna da ƙananan matakan kwayoyin da ake kira bile acid. Bile acid suna da ayyuka da yawa, musamman a cikin narkewa. Hakanan suna da tasirin maganin kumburi akan wasu kwayoyin halitta.

Hakanan an samo masu karɓar bile acid akan ƙwayoyin a cikin ƙwayar MS. Ana tunanin cewa kari tare da bile acid na iya amfani da mutane tare da MS na ci gaba. A zahiri, gwajin asibiti don gwada ainihin wannan yana gudana a halin yanzu.

Takeaway

Asibitoci, jami'o'i, da sauran ƙungiyoyi a duk faɗin Amurka suna ci gaba da aiki don ƙarin koyo game da PPMS da MS gaba ɗaya.

Ya zuwa yanzu magani ɗaya ne kawai, Ocrevus, ya sami izinin FDA don kula da PPMS. Duk da yake Ocrevus yana jinkirin ci gaban PPMS, baya hana ci gaban.

Wasu kwayoyi, kamar su ibudilast, suna da alamar raɗaɗi bisa ga gwajin farko. Sauran kwayoyi, kamar su idebenone da laquinimod, ba a nuna sun yi tasiri ba.

Ana buƙatar ƙarin gwaji don gano ƙarin hanyoyin kwantar da hankali don PPMS. Tambayi mai ba ku kiwon lafiya game da sabon gwaji na asibiti da kuma binciken da zai iya amfanar ku.