Anthu omwe ali ndi chitetezo chamthupi "atha" kufuna chithandizo cha katemera wa COVID-19

Curtis J. Patient webinar: Katemera wa COVID-19 ndi chithandizo. Wokamba: Rheumatism Research Foundation. Meyi 11, 2021 (Virtual Q&A).
Curtis J. Patient webinar: Katemera wa COVID-19 ndi chithandizo. Wokamba: Rheumatism Research Foundation. Meyi 11, 2021 (Virtual Q&A).
Jeffrey R. Curtis, MD, wapampando wa COVID-19 Vaccine Clinical Guidance Working Group of the American Academy of Rheumatology, adati odwala omwe ali ndi vuto la immunosuppressive "mwina" adzafunika kugwiritsa ntchito katemera wa COVID-19 nthawi zonse mtsogolo.
Curtis, rheumatologist, epidemiologist, komanso pulofesa wa zamankhwala ku University of Alabama ku Birmingham, adauza omwe adapezeka pamwambo waposachedwa wa Q&A womwe wachitika ndi Rheumatology Research Foundation kuti akukhulupirira kuti katemera wa COVID-19 atha kukhala wamba mwa odwalawa.
“N’zoona kuti pali sayansi yambiri, ndipo sayansi ikusintha mosalekeza. Chilichonse chomwe mukuganiza kuti mukudziwa mwezi uno, mwezi wamawa chikhoza kukhala chosiyana, chifukwa chake, ndikuganiza kuti zonse zomwe timanena kapena kukambirana usikuuno zitha kusintha, "Curtis adauza omwe adapezeka pamsonkhanowo. "Ineyo ndikuganiza kuti anthu angafunike zowonjezera. Sizingakhale choncho kwa aliyense, koma ndikuganiza kuti zingakhale zachilendo kupeza chilimbikitso ndikuchita nthawi ndi nthawi. Atha kukhala ngati katemera wa chimfine, ngati sichoncho chaka chilichonse, ndiye kuti umafunikira chaka chilichonse. ”
Ananenanso kuti kutengera chithandizo chomwe wodwala amalandira, anthu amathanso kupindula ndi katemera wowonjezera kapena katemera wobwerezabwereza.
"Wina pamacheza adawonetsa kuti mwina sangakhale mlingo kapena katemera womwe akufuna, chifukwa chake kutengera chithandizo chomwe mumalandira, ichi ndi chinthu choti mukambirane ndi wothandizira zaumoyo," adatero Curtis. "Koma ndikuganiza kwambiri kuti lingaliro la zolimbikitsa liyenera kukhala lokongola."
Atafunsidwa za chiyembekezo chogwiritsa ntchito katemera wa Pfizer kapena Moderna ndi chowonjezera cha kampani ina, Curtis adayankha kuti akuyembekeza kuti akatswiri angalimbikitse kuti anthu apitilize kugwiritsa ntchito katemerayu ngati katemera woyamba.
Iye anati: “N’zosakayikitsa kuti limeneli silikhala phunziro lathunthu posachedwapa.” “Ndili wodzala ndi ziyembekezo. Muyenera kumamatira ku chithandizo chomwe munalandira kuyambira pachiyambi. "
Curtis adafotokozanso za mankhwala ena a rheumatic, kuphatikiza rituximab (Rituxan, Genentech) ndi mycophenolate mofetil, zomwe zingachepetse mphamvu ya katemera wa COVID-19.
Anati: "Ndikuganiza kuti Rituximab ikhala imodzi mwamankhwala osangalatsa kwambiri." Rituximab ndiwothandiza kwambiri pochotsa ma cell a B ndikupangitsa kuti zikhale zovuta kuti thupi lipange ma antibodies. Ichi ndi chinthu chabwino pamene mukuchiza chinachake ndi ma antibodies omwe mukufuna kuchotsa, koma ngati mukufuna kuthandiza chitetezo cha mthupi kulimbana ndi matenda m'tsogolomu, sichingakhale chinthu chabwino. ”
Rituximab ikhoza kuchepetsa kuyankha kwa chitetezo chamthupi kumlingo wokulirapo kuposa mankhwala ena ambiri. Mycophenolate mofetil ndi ina. "Izi ndi zinthu ziwiri zomwe ndingazengereze kwambiri, kuti nditsimikizire kuti wina ali wotetezedwa ku COVID-19."
Malinga ndi Curtis, nkhani kuphatikiza ma JAK inhibitors komanso kuchepa kwa katemera, kuphatikiza gulu la ACR COVID-19 Vaccine Clinical Guidance Working Group nawonso akopa chidwi.
Curtis anati: “Ndichifukwa chake ena a iwo amanena kuti ngati n’kotheka, kulandira chithandizo kwanthaŵi yochepa kungakhale kwanzeru.” "Ili si chenjezo wamba, muyenera kuchita izi zivute zitani, koma ndi rheumatism yanu Lankhulani ndi dokotala wodwala. ACR yapeza malingaliro aposachedwa kuchokera ku gulu lotsogolera, ndipo malingaliro awa adapangidwa m'masiku angapo apitawa. "
Kafukufuku watsopano wofalitsidwa mu Gut adapeza kuti odwala omwe ali ndi matenda otupa omwe adalandira infliximab anali ndi kuchepa kwa chitetezo chamthupi ku katemera wa COVID-19 atangolandira jakisoni woyamba (Remicade, Janssen). Komabe, pamene wodwala yemweyo pambuyo pake analandira mlingo wachiwiri wa chithandizo, kuyankha kwa chitetezo chathupi kumawoneka ngati kwachibadwa.
Malingana ndi Curtis, izi zawonjezera nthawi yolandira mlingo wachiwiri kuti mupulumutse Mlingo m'mayiko ena, osati kwa IBD ndi infliximab, komanso kwa odwala omwe ali ndi matenda ambiri a autoimmune ndi mankhwala.
"Ngati mukukhala m'dziko lina ndipo US si m'modzi mwa iwo, ndiye kuti muwonjezere nthawi kuchokera pa mlingo woyamba mpaka wachiwiri kuti mupulumutse mlingo kuti aliyense athe kutenga mlingo woyamba. Ndikuganiza, Ili silingakhale lingaliro labwino kwa anthu omwe akudwala matenda a Crohn's kapena lupus, vasculitis, nyamakazi ya nyamakazi kapena matenda ena. ” Curtis. "Kwenikweni, sikuti infliximab yokha, komanso Remicade ndi [biosimilars] Inflectra ndi Renflexis. Ndimakayikiranso kuti mankhwala athu ambiri ndi ofanana.”
Anawonjezeranso kuti tsopano pali maphunziro angapo okhudza momwe odwala omwe ali ndi matenda a autoimmune a katemera wa COVID-19 atatha Mlingo woyamba ndi wachiwiri. Zotsatira zikuwonetsa kuti ma antibodies athunthu adzapangidwa kokha pakatha katemera wathunthu. yankho.
Curtis adati: "Tsopano, pali maphunziro ena m'mabuku, amaphunzira zomwe zimachitika atamwa mlingo woyamba." Kuyankha kwa katemera wa anthu ambiri ndikwabwino, koma kwa anthu ambiri, zotsatira zake sizabwino kwambiri. Chifukwa chake, ndikuganiza kuti chidziwitso chachikulu chomwe ndidaphunzira m'mipukutu ina yomwe ndidawunikiranso ili pagulu, ndipo zina zidatumizidwa kwa ine mobisa, ndipo muyenera kuvomereza mlingo wachiwiri.
"Izi ndizowona makamaka ngati muli ndi matenda a autoimmune kapena mukulandira chithandizo chomwe chimakhudza chitetezo chamthupi, chifukwa pokhapokha mutamaliza maphunziro onse monga momwe amayembekezerera, anthu ena apitiliza kukhala pachiwopsezo ndipo yankho lomwe limayembekezereka lisanakwaniritsidwe, Adapeza. mlingo wachiwiri.” Iye anawonjezera. "Ndiye, nthawi zambiri, odwala matenda a rheumatism amawoneka otetezedwa atalandiranso mlingo wachiwiri, koma pali zosiyana."

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