Clinical trials
Sarudzo yemishonga inorwisa fungal pamusika idiki, uye pane zvipimo pane izvo izvo NHS inogona kuraira. Mazhinji emhando dzefungus akashanduka kurwisa mishonga yakawanda, uye hutsinye mhedzisiro inoreva kuti vamwe varwere havagone kushivirira mamwe madhiragi, saka pane kudiwa kwakanyanya kwemaantifungal matsva, kubva kumakirasi matsva ayo asati abatwa nekuramba.
Mishonga mitsva inotenderwa sei
Kuwana mushonga mutsva ubvumidzwe inguva refu uye inodhura iyo inowanzopfuura nematanho anotevera:
| Basic research | Kudzidza nezvechirwere uye kutsvaga ma molecular targets emishonga mitsva yekushandisa kurwisa. |
|---|---|
| Kuwanikwa kwezvinodhaka | Kuongorora maraibhurari emakemikari, kana kugadzirisa zvimiro zveanovimbisa makomisheni. |
| Pre-kiriniki zvidzidzo | Kuongorora kuti mushonga mutsva unogona kushanda zvakanaka sei muchubhu yekuyedza kana modhi yemhuka. |
| Chikumbiro chekutanga miedzo yevanhu | |
| Phase 0 uye I | Kuongorora mushonga mune vanozvipira vane hutano, kuti vaone zvinoitika kumushonga uri mukati memuviri - kuti wakapinzwa zvakanaka sei muropa, wakagoverwa kune akakodzera tishu (semumapapu), wakagadzirwa nemagetsi uye unobviswa kuburikidza neweti / tsvina. Izvi zvinobatsira vaongorori kusarudza kuti ndeapi madhasi ekushandisa mumiedzo. |
| Phase II | Kuedza mushonga mumazana akati wandei evarwere vane mamiriro acho, kuona kuti ndeipi dosi inonyanya kushanda uye kuwana zano repi zvakajairika mhedzisiro. |
| Phase III | Kuedza mushonga mumazana akati wandei kusvika kuzviuru zvevarwere vane mamiriro acho, kunyatsoyera kuti mushonga unobata sei chirwere ichi uye kuti kangani unoburitsa imwe neimwe mhedzisiro. |
| Chikumbiro chemvumo yezvinodhaka | Kunyorera kuEMA (Europe) kana kambani inodzora mishonga yakanangana nenyika yakaita seFDA (US) kuti uwane mvumo yekutanga kutengesa mushonga. |
| NICE wongororo | Kufunga kuti mushonga uyu unobatsira zvakakwana here kuti uve wakakodzera mutengo kuNHS |
| Kutumira / kubhadhara mari | Kana NICE isingakurudzire mushonga wekushandisa nguva nenguva (izvo zvave zvakadaro kune akawanda antifungals), chiremba anogona achiri kunyorera kumurwere kana CCG yemunharaunda yavo yakabvuma kuibhadhara. Iyo NAC inyanzvi yeCCG ine rusununguko rwakawedzerwa rwekutaura mamwe maantifungal, uye mamwe mayuniti ekutapurirana anogona kupa antifungal prophylaxis. |
| Chikamu IV | Iyo inozivikanwawo se post-marketing. Kutarisa kuti mushonga unoshanda here sezvaunotarisirwa mu 'nyika chaiyo'. |
Verenga zvakawanda nezve maitiro ekubvumidza: Pharmaceutical Journal or Van Norman (2016)
CCG = Clinical Commissioning Group
Ndeapi mishonga mitsva iri mukuedzwa kweaspergillosis?
Mishonga mitsva inowanzobvumidzwa kune invasive aspergillosis pamberi peCPA/ABPA.
- Olorofim inyowani antifungal kubva kukirasi nyowani yemishonga (iyo orotomides). Iri kugadzirwa ne F2G Ltd, inova kambani inotenderera ine vanachipangamazano vanosanganisira Muzvinafundo Denning. Olorofim yakapfuura nemuyedzo dzakasiyana dzeChikamu I, Phase II miedzo uye nguva pfupi yadarika (Kurume 2022) yakapinda muyedzo yeChikamu III kuti ione kuti inoshanda sei muvarwere mazana maviri nemakumi maviri nevaviri vane hutachiona hwefungal.
- Rezafungin imhando ye echinocandin drug, izvi zvinoshanda nekudzivisa fungal cell wall components zvakakosha kune homeostasis. Iri kugadzirwa kuchengetedza kuchengetedzeka kwemamwe echinocandins uku iine yakasimba pharmokinetic zvivakwa. Ikozvino iri muchikamu chechitatu chemiedzo.
- Ibrexafungerp ndiyo yekutanga yekirasi nyowani yeantifungals inonzi Triterpenoids. Ibrexafungerp inoshanda nenzira yakafanana kune echinocandins, asi ine chimiro chakasiyana zvachose, ichiita kuti ive yakagadzikana uye zvinoreva kuti inogona kupihwa nemuromo. Kune maviri arikuenderera chikamu 3 miedzo yebrexafungerp. Imwe ichive chidzidzo cheFURI chinosanganisira mazana maviri vatori vechikamu vane invasive uye/kana yakaoma fungal chirwere.
- Fosmanogepix ari afirst of its kind antifungal iyo inovhara kugadzirwa kwekomboni yakakosha iyo yakakosha pakuvaka kwesero rusvingo uye kuzvitonga. Ichangobva kupedza chikamu chechipiri chekuedza icho chaisanganisira vatori vechikamu 21.
- Oteseconazole ndiyo yekutanga yeakawanda tetrazole agents akagadzirwa nechinangwa chekusarudza kukuru, mashoma mhedzisiro, uye kuvandudzwa kwesimba zvichienzaniswa neazoles aripo iye zvino. It iri muchikamu chechitatu chebudiriro uye parizvino iri pasi peFDA yekutarisisa kubvumidzwa kurapa inodzokororwa vulvovaginal candidiasis.
- Encochleated Amphotericin B imhando yePolyene inouraya fungi nekusunga kune ergosterol iyo inoshanda kuchengetedza cell membrane kuperera. Nekudaro, maPolyenes anodyidzanawo necholesterol mumasero emunhu membranes, zvichireva kuti ane huturu hwakakosha. Encochleated Amphotericin B yakagadziridzwa kudzivirira izvi zvakakosha muchetura uye parizvino iri muchikamu 1 & 2 chebudiriro.
- ATI-2307 imhando yeArylamidine iyo inhibits mitochondrial basa mumbiriso saka ichitadzisa kukura. Yakapedza nhanho nhatu dzechikamu I uye yakagadzirira kupinda muchikamu chechipiri muna 2022.
Dzvanya pano kuti uwane rumwe ruzivo nezvemushonga wega wega
Maitiro ekutsvaga ruzivo nezve aspergillosis miedzo
Miedzo yemakiriniki inofanirwa kunyoreswa pachena nekuda kwezvikonzero zvehunhu (nekuti inosanganisira zvidzidzo zvevanhu). Unogona kushandisa clinicaltrials.gov kutsvaga zviedzo zvaungakodzere kutora chinhano mazviri, kana kutsvaga mibairo yemiedzo ichangopedzwa.
Kana usiri kugadzikana nenjodzi dziripo mukuyedza mushonga mutsva, unogona kuzvipira kuita registry kana diagnostics/biomarker study pane kudaro. Miedzo mizhinji inotarisa kuti tingashandise sei mishonga iripo mumiyedzo mitsva kana misanganiswa mitsva, kana mumapoka akasiyana evarwere semuenzaniso. ATCFItraconazole/voriconazole kune varwere vane cystic fibrosis vane sputum inoramba ichibatsira. Aspergillus.
