Uvavanyo lwezonyango
Ukukhethwa kwamachiza e-antifungal kwimarike kuncinci, kwaye kukho imida apho i-NHS inokumisela khona. Iintlobo ezininzi zefungus ziye zavela ukuxhathisa kumachiza amaninzi, kwaye iziphumo ebezingalindelekanga eziqatha zithetha ukuba ezinye izigulana azikwazi ukunyamezela amayeza athile, ngoko kukho imfuneko engxamisekileyo yee-antifungals ezintsha, ezisuka kwiiklasi ezintsha ezingekachatshazelwa kukuxhathisa.
Avunywa njani amachiza amatsha
Ukufumana iyeza elitsha elivunyiweyo yinkqubo ende nedulu edla ngokuhamba kwezi zigaba zilandelayo:
| Uphando olusisiseko | Ukufunda ngesi sifo kunye nokukhangela iithagethi zeemolekyuli zamachiza amatsha aza kusetyenziswa ngokuchaseneyo. |
|---|---|
| Ukufunyanwa kweziyobisi | Ukuhlola iilayibrari zeekhemikhali, okanye ukuguqula izakhiwo zeekhompawundi ezithembisayo. |
| Izifundo zangaphambi kweklinikhi | Ukuvavanya ukuba ichiza elitsha elinokubakho lisebenza njani kwityhubhu yovavanyo okanye imodeli yezilwanyana. |
| Isicelo sokuqalisa izilingo zabantu | |
| Isigaba 0 kunye ne | Ukuvavanya ichiza kumavolontiya asempilweni, ukubona ukuba kwenzeka ntoni kwichiza ngaphakathi emzimbeni – ukuba lifunxeka kakuhle kangakanani na kumjikelezo wegazi, lisasazwe kwizihlunu ezifanelekileyo (umz. imiphunga), lenziwe imetabolise kwaye likhutshwe ngomchamo/ilindle. Oku kunceda abaphandi bagqibe ukuba loluphi uluhlu lweedosi ekufuneka zisetyenziswe kulingo. |
| Isigaba II | Ukuvavanya iyeza kumakhulu aliqela ezigulane ezinemeko, ukubona ukuba yeyiphi idosi esebenza kakhulu kwaye ufumane umbono wazo naziphi na iziphumo ebezingalindelekanga eziqhelekileyo. |
| Isigaba III | Ukuvavanya ichiza kumakhulu aliqela ukuya kumawaka aliqela ezigulane ezinemeko, ukulinganisa ngokuchanekileyo ukuba ichiza lisiphatha kangakanani isifo kunye nokuba livelisa kangakanani isiphumo esisecaleni. |
| Isicelo sokuvunywa kweziyobisi | Ukufaka isicelo kwi-EMA (eYurophu) okanye i-arhente elawula amayeza elizwe ngalinye efana ne-FDA (US) ukuze ufumane imvume yokuqalisa ukuthengisa ichiza. |
| Uvavanyo oluhle | Ukwenza isigqibo sokuba ichiza liluncedo ngokwaneleyo ukuba lilenze lixabiseke iindleko kwi-NHS |
| Ukugunyaziswa / inkxaso-mali | Ukuba i-NICE ayicebisi ichiza lokusetyenziswa kwesiqhelo (ebeyimeko ye-antifungals ezininzi), ugqirha usenako ukulinika isigulana ukuba i-CCG yabo yendawo iyavuma ukuyixhasa ngemali. I-NAC yincutshe yeCCG enenkululeko eyongezelelweyo yokumisela amayeza athile okulwa nokungunda, kwaye ezinye iiyunithi zoqhaqho-fakelo zinokumisela i-antifungal prophylaxis. |
| Isigaba IV | Ikwabizwa ngokuba yi-post-marketing. Ukujonga ukuba ichiza lisebenza kakuhle na njengoko kulindelekile 'kwilizwe lokwenyani'. |
Funda ngakumbi ngenkqubo yokwamkelwa: Ijenali yezamayeza or Van Norman (2016)
I-CCG = iQela lokuKhomisa iKlinikhi
Ngawaphi amayeza amatsha akulingo ngoku lwe-aspergillosis?
Amachiza amatsha akholisa ukuvunywa kwi-invasive aspergillosis phambi kwe-CPA/ABPA.
- Olorofim iyinoveli ye-antifungal evela kudidi olutsha ngokupheleleyo lwamachiza (i-orotomides). Iyaphuhliswa ngu F2G Ltd, eyinkampani ejikelezayo abacebisi bayo baquka uNjingalwazi uDenning. I-Olorofim idlule kulingo olwahlukeneyo lweSigaba soku-I, ulingo lweSigaba sesi-II kwaye kutsha nje (ngoMatshi ka-2022) ingene kulingo lweSigaba sesi-III ukubona ukuba lusebenza kakuhle kangakanani na kwizigulane ezingama-225 ezinosulelo lomngundo oluhlaselayo.
- Rezafungin luhlobo lwechiza le-echinocandin, ezi zisebenza ngokuthintela amacandelo odonga lweseli lomngundo oluyimfuneko kwi-homeostasis. Iphuhliswa ukugcina ukhuseleko lwezinye ii-echinocandins ngelixa zineempawu ezomeleleyo ze-pharmokinetic. Ngoku ikwisigaba sesi-III solingo.
- Ibrexafuningerp ngowokuqala kwiklasi entsha ye-antifungals ebizwa ngokuba yi-Triterpenoids. Ibrexafungerp isebenza ngendlela efanayo kwi-echinocandins, kodwa inesakhiwo esahluke ngokupheleleyo, esenza ukuba izinze ngakumbi kwaye intsingiselo inokunikwa ngomlomo. Kukho izilingo ezimbini eziqhubekayo zesigaba sesi-3 se-ibrexafungerp. Olunye luphononongo lweFURI olubandakanya abathathi-nxaxheba abangama-200 abanesifo sokungunda esihlaselayo kunye/okanye esiqatha.
- Fosmanogepix yi afIrst of its kind antifungal ethintela ukuveliswa kwekhompawundi ebalulekileyo ebalulekileyo kukwakhiwa kodonga lweseli kunye nokuzilawula. Isanda kugqiba ulingo lwayo lwesigaba II esibandakanya abathathi-nxaxheba abangama-21.
- Oteseconazole ngowokuqala kwii-agent ezininzi ze-tetrazole eziyilwe ngenjongo yokukhethwa okukhulu, imiphumo embalwa yecala, kunye nokuphucula ukusebenza kakuhle xa kuthelekiswa ne-azoles ekhoyo ngoku. Yona ikwisigaba sesi-3 sophuhliso kwaye ngoku iphantsi koqwalaselo lwe-FDA ukuze yamkelwe ukunyanga i-vulvovaginal candidiasis.
- I-Encochleated Amphotericin B luhlobo lwePolyene ebulala umngundo ngokuzibophelela kwiergosterol esebenza ukugcina ingqibelelo yenwebu yeseli. Nangona kunjalo, iiPolyenes zikwanxibelelana ne-cholesterol kwiinwebu zeeseli zomntu, okuthetha ukuba zinetyhefu enkulu. I-Encochleated Amphotericin B yenzelwe ukuthintela ezi tyhefu zibalulekileyo kwaye ngoku ikwisigaba 1 & 2 sophuhliso.
- ATI-2307 luhlobo lwe-Arylamidine ethintela umsebenzi we-mitochondrial kwigwele ngoko ke inqanda ukukhula. Igqibe ulingo lwesigaba I esithathu kwaye imiselwe ukungena kulingo lwesigaba II ngo-2022.
Cofa apha ukuze ufumane iinkcukacha ezithe vetshe malunga nechiza ngalinye
Indlela yokukhangela ulwazi malunga nolingo lwe-aspergillosis
Ulingo lwezonyango kufuneka lubhaliswe esidlangalaleni ngenxa yezizathu zokuziphatha (kuba zibandakanya izifundo zabantu). Ungasebenzisa klinikhi.gov ukukhangela ulingo onokuthi uvumeleke ukuba uthathe inxaxheba kulo, okanye ufumane iziphumo zolingo olusanda kugqitywa.
Ukuba awukhululekanga ngeengozi ezibandakanyekayo ekuvavanyeni ichiza elitsha, ungavolontiya kubhaliso okanye uphononongo/uphononongo lwe-biomarker endaweni yoko. Ulingo oluninzi lujonga ukuba singasebenzisa njani na amayeza asele ekhona kwiidosi ezintsha okanye indibaniselwano emitsha, okanye kumaqela ahlukeneyo ezigulane umz. ATCFItraconazole/voriconazole kwizigulana ezinecystic fibrosis ezinesikhohlela esithe gqolo ukuba sinethemba. I-Aspergillus.
