Sohle seo u hlokang ho se tseba mabapi le kalafo tsa morao-rao tsa Psoriasis

Litaba

• New biologics
• Risankizumab-rzaa (Skyrizi)
• Pegol ea setifikeiti (Cimzia)
• Tildrakizumab-asmn (Ilumya)
• Guselkumab (Tremfya)
• Brodalumab (Siliq)
• Ixekizumab (Taltz)
• Li-biosimilars
• Li-biosimilars ho adalimumab (Humira)
• Li-biosimilars ho etanercept (Enbrel)
• Li-biosimilars ho infliximab (Remicade)
• Litlhare tse ncha tsa lihlooho
• Litlolo tsa Halobetasol propionate-tazarotene, 0.01% / 0.045% (Duobrii)
• Foam ea Halobetasol propionate, 0.05% (Lexette)
• Litlolo tsa halobetasol propionate, 0,01% (Bryhali)
• Ho fafatsa Betamethasone dipropionate, 0.05% (Sernivo)
• Kalafo e ncha bakeng sa bana
• Foam ea Calcipotriene, 0.005% (Sorilux)
• Calcipotriene-betamethasone dipropionate foam, 0.005% / 0.064% (Enstilar)
• Ho emisoa ha lihlooho tsa methapo ea calcipotriene-betamethasone dipropionate, 0.005% / 0.064% (Taclonex)
• Ustekinumab (Stelara)
• Etanercept (Enbrel)
• Litlhare tse ling li haufi le ho amoheloa
• Bimekizumab
• Setlolo sa calcipotriene-betamethasone dipropionate, 0.005% / 0.064% (Wynzora)
• JAK inhibitors
• Tsa Tsau-tsau

Bafuputsi ba ithutile ho hongata haholo lilemong tsa morao tjena ka psoriasis le karolo eo sesole sa 'mele sa' mele se e bapalang boemong bona. Lits'ibollo tsena tse ncha li lebisitse liphekolo tse sireletsehileng, tse shebiloeng haholoanyane le tse sebetsang haholoanyane tsa psoriasis.

Leha liphekolo tsohle li le teng, liphuputso li bonts'a hore batho ba bangata ba fumanang kalafo ea psoriasis ha ba khotsofalle kalafo ea bona kapa ba khotsofetse ka boinyenyefatso feela.

Haeba u batla ho fetola kalafo hobane ea hau ea hajoale ha e sa sebetsa kapa u na le litla-morao, ke mohopolo o motle ho ithuta ka hohle kamoo ho ka khonehang ka likhetho tsa moraorao.

New biologics

Biologics e entsoe ka lintho tse fumanoang linthong tse phelang, joalo ka liprotheine, tsoekere, kapa li-acid tsa nucleic. Hang ha o le 'meleng, meriana ena e thibela karolo ea sesole sa' mele e tlatsetsang matšoao a hau a psoriasis.

Biologics e kena-kenana le tse latelang:

• hlahala necrosis factor alpha (TNF-alpha), e leng protheine e khothalletsang ho ruruha 'meleng
• Lisele tsa T, tse lisele tse tšoeu tsa mali
• li-interleukin, e leng li-cytokine (liprotheine tse nyane tsa ho ruruha) tse amehang ho psoriasis

Ho kena-kenana hona ho thusa ho fokotsa ho ruruha.

Risankizumab-rzaa (Skyrizi)

Risankizumab-rzaa (Skyrizi) e ile ea amoheloa ke Tsamaiso ea Lijo le Lithethefatsi ka FDA ka Mmesa 2019.

E etselitsoe batho ba nang le plaque psoriasis e itekanetseng le e matla ba khethiloeng bakeng sa phototherapy (light therapy) kapa kalafo ea systemic (ea mmele ka bophara).

Skyrizi e sebetsa ka ho thibela ts'ebetso ea interleukin-23 (IL-23).

Mokhahlelo o mong le o mong o na le liente tse peli tse katang ka tlasa letlalo. Mekhahlelo e 'meli ea pele e arotsoe ka libeke tse 4. Tse ling li fuoa hang ka mor'a likhoeli tse 3.

Litla-morao tsa Skyrizi ke tsena:

• mafu a holimo a ho hema
• liphetoho sebakeng sa ente
• hlooho e opang
• mokgathala
• mafu a fungal

Pegol ea setifikeiti (Cimzia)

FDA e amohetse certolizumab pegol (Cimzia) joalo ka kalafo ea psoriasis ka Mots'eanong 2018. E ne e kile ea amoheloa pele ho phekola maemo a kang lefu la Crohn le lefu la psoriatic ramatiki (PsA).

Cimzia e phekola psoriasis ea plaque e leka-lekaneng ho ea ho batho ba khethiloeng bakeng sa phototherapy kapa kalafo ea systemic. E sebetsa ka ho supa protheine ea TNF-alpha.

Lithethefatsi li fanoa e le liente tse peli tse kenang ka tlasa beke le beke.

Litla-morao tse tloaelehileng tsa Cimzia ke tsena:

• tšoaetso e kaholimo ea phefumoloho
• lekhopho
• tšoaetso ea urinary tract (UTIs)

Tildrakizumab-asmn (Ilumya)

Tildrakizumab-asmn (Ilumya) e ile ea amoheloa ke FDA ka Hlakubele 2018. E sebelisetsoa ho phekola plaque psoriasis ho batho ba baholo ba khethiloeng bakeng sa phototherapy kapa therapyic systemic.

Lithethefatsi li sebetsa ka ho thibela IL-23.

Ilumya e fanoa e le liente tse ka tlasa letlalo. Liente tse peli tsa pele li arohane ka libeke tse 4. Ho tloha ka nako eo ho ea pele, liente li fuoa likhoeli tse 3 ka thoko.

Litla-morao tsa mantlha tsa Ilumya ke tsena:

• liphetoho sebakeng sa ente
• mafu a holimo a ho hema
• letšollo

Guselkumab (Tremfya)

Guselkumab (Tremfya) e ile ea amoheloa ke FDA ka Phupu 2017. E sebelisetsoa ho phekola psoriasis ea plaque e itekanetseng ho isa ho batho bao le bona e leng bakhethoa ba phototherapy kapa kalafo ea systemic.

Tremfya e ne e le biologic ea pele ho lebisa IL-23.

Litekanyo tsa pele tse peli tsa ho qala li fuoa libeke tse 4 ka thoko. Kamora moo, Tremfya e fuoa ente e kenang ka tlasa libeke tse ling le tse ling tse 8.

Litla-morao tse tloaelehileng li kenyelletsa:

• hlooho e opang
• mafu a holimo a ho hema
• liphetoho sebakeng sa ente
• bohloko ba manonyeletso
• letšollo
• ntaramane ea mala

Brodalumab (Siliq)

Brodalumab (Siliq) e ile ea amoheloa ke FDA ka Hlakubele 2017. E etselitsoe batho ba fihlelang litekanyetso tse latelang:

• na le psoriasis ea plaque e mahareng ho isa ho e matla
• ke ba khethiloeng bakeng sa phototherapy kapa systemic therapy
• psoriasis ea bona ha e arabele mekhoeng e meng ea kalafo ea sistimi

E sebetsa ka ho tlama mokelikeli oa IL-17. Tsela ea IL-17 e bapala karolo ea ho ruruha mme e nka karolo ho nts'etsopele ea maballo a psoriasis.

Litekong tsa bongaka, barupeluoa ba ileng ba phekoloa le Siliq ba ne ba le monyetla o moholo ho feta ba fumaneng placebo ho ba le letlalo le nkoang le hlakile kapa le batla le hlakile.

Siliq e tsamaisoa joalo ka ente. Haeba ngaka ea hao eu laela hore u noe moriana, u tla fumana ente e le 'ngoe ka beke bakeng sa libeke tse 3 tse qalang. Kamora moo, o tla fumana ente e le 'ngoe libeke tse ling le tse ling tse 2.

Joaloka li-biologics tse ling, Siliq e eketsa menyetla ea ho tšoaetsoa. Leibole ea sethethefatsi sena le eona e na le tlhokomeliso e lebokoseng le letšo mabapi le kotsi e kholo ea menahano le boits'oaro ba ho ipolaea.

Batho ba nang le nalane ea boits'oaro ba ho ipolaea kapa khatello ea maikutlo ba lokela ho beoa leihlo ha ba nka brodalumab.

Ixekizumab (Taltz)

Ixekizumab (Taltz) e ile ea amoheloa ke FDA ka Hlakubele 2016 ho phekola batho ba baholo ba nang le psoriasis e mahareng le e matla. E etselitsoe batho ba khethiloeng bakeng sa Phototherapy, systemic therapy, kapa ka bobeli.

Taltz e shebile protheine IL-17A.

Ke sethethefatsi se entsoang. U tla fumana liente tse peli ka letsatsi la hau la pele, liente libekeng tse ling le tse ling tse 2 likhoeling tse 3 tse tlang, le liente libekeng tse ling le tse ling tse 4 bakeng sa kalafo ea hau e setseng.

Kamohelo e ne e ipapisitse le liphetho tsa lithuto tse ngata tsa bongaka tse nang le bankakarolo ba 3,866 kaofela. Lithutong tseo, batho ba bangata ba noang moriana ba fihletse letlalo le hlakileng kapa le hlakileng.

Litla-morao tse tloaelehileng tsa Taltz li kenyelletsa:

• mafu a holimo a ho hema
• liphetoho sebakeng sa ente
• mafu a fungal

Li-biosimilars

Li-biosimilars ha li tšoane hantle le biologics. Ho e-na le hoo, li entsoe ka mokhoa o feto-fetohang ho hlahisa litholoana tse tšoanang le tsa biologics.

Joalo ka lithethefatsi tse tloaelehileng, li-biosimilars li etsoa hang ha biologic ea mantlha e tsoa ho patent. Molemo oa li-biosimilars ke hore hangata li theko e tlase haholo ho feta sehlahisoa sa mantlha.

Li-biosimilars tsa psoriasis li kenyelletsa tse latelang:

Li-biosimilars ho adalimumab (Humira)

• adalimumab-adaz (Hyrimoz)
• adalimumab-adbm (Cyltezo)
• adalimumab-afzb (Abrilada)
• adalimumab-atto (Amjevita)
• adalimumab-bwwd (Hadlima)

Li-biosimilars ho etanercept (Enbrel)

• etanercept-szzs (Erelzi)
• etanercept-ykro (Eticovo)

Li-biosimilars ho infliximab (Remicade)

• infliximab-abda (Renflexis)
• infliximab-axxq (Avsola)
• infliximab-dyyb (Khathatso)

Remicade biosimilar Inflectra e bile eona ea pele ea psoriasis biosimilar ho amohela tumello ea FDA. E ne e le ka Mmesa 2016.

Inflectra le Renflexis, e 'ngoe hape ea Remicade biosimilar, ke tsona feela tse fumanehang hona joale ho rekoa United States. Sena ke haholo-holo hobane litokelo tsa molao tse tšoaretsoeng ke baetsi ba biologics ha li e-so felloe ke nako.

Litlhare tse ncha tsa lihlooho

Kalafo ea lihlooho, kapa tseo u itlotsang ka tsona letlalong la hau, hangata ke tsona kalafo ea pele eo lingaka li e khothalletsang psoriasis. Li sebetsa ka ho fokotsa ho ruruha le ho liehisa tlhahiso e fetelletseng ea lisele tsa letlalo.

Litlolo tsa Halobetasol propionate-tazarotene, 0.01% / 0.045% (Duobrii)

Ka Mmesa 2019, FDA e amohetse litlolo tsa halobetasol propionate-tazarotene, liperesente tsa 0.01 / liperesente tsa 0.045 (Duobrii) bakeng sa kalafo ea plaque psoriasis ho batho ba baholo.

Duobrii ke setlolo sa pele sa ho kopanya corticosteroid (halobetasol propionate) le retinoid (tazarotene). Corticosteroid e khahlanong le ho ruruha e hlakola matlapa, ha li-retinoid tse nang le vithamine A li beha kholo e feteletseng ea lisele tsa letlalo.

Duobrii e sebelisoa hang ka letsatsi libakeng tse anngoeng ke letlalo.

Litla-morao tse kholo ke:

• bohloko sebakeng sa kopo
• lekhopho
• folliculitis, kapa moriri o ruruhileng
• ho roala letlalo moo ho tlotsuoang mafura
• excoriation, kapa ho thonaka letlalo

Foam ea Halobetasol propionate, 0.05% (Lexette)

Foam ea Halobetasol propionate, karolo ea 0.05 lekholong ke "corticosteroid" ea lihlooho eo FDA e ileng ea e amohela pele, joalo ka generic, ka Mots'eanong 2018. Ka Mmesa 2019, e ile ea fumaneha tlasa lebitso la lebitso la Lexette.

E sebelisoa ho phekola plaque psoriasis ho batho ba baholo. Morero oa eona ke ho hlakola letlalo.

Habeli ka letsatsi, foam e tlotsoa ka lera e tšesaane ebe e tšeloa letlalong. Lexette e ka sebelisoa ho fihlela libeke tse 2.

Litla-morao tse atileng haholo tsa Lexette ke bohloko setšeng sa kopo le hlooho.

Litlolo tsa halobetasol propionate, 0,01% (Bryhali)

Halobetasol propionate lotion, karolo ea 0.01 lekholong (Bryhali) e ile ea amoheloa ke FDA ka Pulungoana 2018. E etselitsoe batho ba baholo ba nang le plaque psoriasis.

A mang a matšoao ao e thusang ho sebetsana le ona ke:

• ho omella
• ho phalla
• ho ruruha
• leqheka la ho haha

Bryhali e sebelisoa letsatsi le leng le le leng. Litlolo li ka sebelisoa ho fihlela libeke tse 8.

Litla-morao tse tloaelehileng li kenyelletsa:

• tukang
• hlaba
• ho hlohlona
• ho omella
• tšoaetso e kaholimo ea phefumoloho
• tsoekere e phahameng maling

Ho fafatsa Betamethasone dipropionate, 0.05% (Sernivo)

Ka Pherekhong 2016, FDA e amohetse betamethasone dipropionate spray, liperesente tsa 0.05 (Sernivo). Sehlooho sena se tšoara psoriasis e bonolo ho isa ho e leka-lekaneng ho batho ba lilemo li 18 le ho feta.

Sernivo e thusa ho imolla matšoao a psoriasis joalo ka ho hlohlona, ​​ho fofa le bofubelu.

U fafatsa moriana ona oa corticosteroid letlalong habeli ka letsatsi ebe u o tšela ka bonolo. O ka sebelisoa ho fihlela libeke tse 4.

Litla-morao tse tloaelehileng ke:

• ho hlohlona
• tukang
• hlaba
• bohloko sebakeng sa kopo
• letlalo atrophy

Kalafo e ncha bakeng sa bana

Meriana e seng mekae ea psoriasis eo pele e neng e fumaneha feela bakeng sa batho ba baholo e sa tsoa amoheloa ke FDA hore e phekole le bana.

Foam ea Calcipotriene, 0.005% (Sorilux)

Ka 2019, FDA e atolositse tumello ea eona bakeng sa mofuta oa vithamine D o bitsoang calcipotriene foam, liperesente tsa 0.005 (Sorilux). E sebelisetsoa ho phekola plaque psoriasis ea letlalo la hlooho le 'mele.

Ka Mots'eanong, e amohetse tumello ea ho sebelisoa ho bana ba lilemo li 12 ho isa ho tse 17. Ka Pulungoana e latelang, ho ile ha lumelloa ho phekola plaque psoriasis ea letlalo la hlooho le 'mele ho bana ba ka tlase ho lilemo tse 4.

Sorilux e thusa ho liehisa kholo e sa tloaelehang ea lisele tsa letlalo ho psoriasis. Foam ena e sebelisoa libakeng tse anngoeng ke letlalo habeli ka letsatsi ho fihlela libeke tse 8. Haeba matšoao a sa ntlafatse kamora libeke tse 8, etela ngaka ea hau.

Litla-morao tse tloaelehileng ke bofubelu le bohloko sebakeng sa kopo.

Calcipotriene-betamethasone dipropionate foam, 0.005% / 0.064% (Enstilar)

Ka Phupu 2019, FDA e amohetse foam ea calcipotriene-betamethasone dipropionate, 0.005% / 0.064% (Enstilar) e ka sebelisoang ho bacha ba pakeng tsa lilemo tse 12 le 17. E etselitsoe batho ba nang le psoriasis ea plaque.

Calcipotriene e liehisa kholo ea lisele tsa letlalo, ha betamethasone dipropionate e thusa ho fokotsa ho ruruha.

Foam e sebelisoa letsatsi le letsatsi ho fihlela libeke tse 4.

Litla-morao tse tloaelehileng li kenyelletsa:

• ho hlohlona
• folliculitis
• lekhopho le nang le makukuno a bofubelu kapa mahare
• ho mpefala ha psoriasis

Ho emisoa ha lihlooho tsa methapo ea calcipotriene-betamethasone dipropionate, 0.005% / 0.064% (Taclonex)

Ka Phupu 2019, calcipotriene-betamethasone dipropionate topical suspension, 0.005% / 0.064% (Taclonex) le eona e ile ea amoheloa ke FDA hore e ka sebelisoa ho bana ba lilemo li 12 ho isa ho 17 ba nang le plaque psoriasis ea 'mele.

Ho emisoa ha lihlooho tsa lihlooho ho ne ho kile ha amoheloa ke FDA bakeng sa bana ba lilemo li 12 ho isa ho 17 ba nang le lejoe la psoriasis la letlalo la hlooho. Setlolo sa Taclonex se kile sa amoheloa ke FDA bakeng sa bacha le batho ba baholo ba nang le plaque psoriasis.

Ho emisoa ha li-topical tsa Taclonex ho sebelisoa letsatsi le letsatsi ho fihlela libeke tse 8. Bakeng sa bana ba lilemo li 12 ho isa ho tse 17, litekanyetso tse phahameng tsa beke le beke ke ligrama tse 60 (g). Tekanyo e phahameng ea beke le beke bakeng sa batho ba baholo ke 100 g.

Litla-morao tse tloaelehileng li kenyelletsa:

• ho hlohlona
• tukang
• ho koata
• bokhubedu
• folliculitis

Ustekinumab (Stelara)

Ka Mphalane 2017, FDA e amohetse ustekinumab (Stelara) bakeng sa bacha ba lilemo li 12 ho ea holimo. E ka sebelisoa bakeng sa bacha ba nang le plaque psoriasis e itekanetseng ho isa bohatong ba khethiloeng bakeng sa phototherapy kapa systemic therapy.

Kamohelo e fihlile kamora phuputso ea 2015 e fumane hore moriana o hloekisitse letlalo haholo kamora likhoeli tsa 3. Mabapi le tokiso ea letlalo le polokeho, liphetho li ne li ts'oana le tse bonoang ho batho ba baholo.

Stelara e thibela liprotheine tse peli tse bohlokoa molemong oa ho ruruha, IL-12 le IL-23.

E fanoa e le ente e kenang ka tlasa letlalo. Dosing e thehiloe boima ba 'mele:

• Bacha ba boima bo ka tlase ho lik'hilograma tse 60 ba fumana limiligrama tse 0,75 ka kilograma ea boima ba 'mele.
• Bacha ba boima ba lipakeng tsa 60 kg (132 lbs.) Le 100 kg (220 lbs.) Ba fumana lethal dose ea 45-mg.
• Bacha ba boima bo fetang lik'hilograma tse 100 ba fumana 90 mg, e leng tekanyetso e tloaelehileng bakeng sa batho ba baholo ba boima bo lekanang.

Mekhahlelo e 'meli ea pele e fuoa libeke tse 4 ka thoko. Ka mor'a moo, moriana o fuoa hanngoe ka mor'a likhoeli tse 3.

Litla-morao tse tloaelehileng ke:

• sefuba le mafu a mang a ka holimo a tšoaetso ea phefumoloho
• hlooho e opang
• mokgathala

Etanercept (Enbrel)

Ka Pherekhong 2016, FDA e amohetse etanercept (Enbrel) ho phekola psoriasis ea plaque e sa foleng ho bana ba lilemo li 4 ho isa ho tse 17 ba khethiloeng bakeng sa phototherapy kapa kalafo ea systemic.

Enbrel e amohetsoe ho phekola batho ba baholo ba nang le plaque psoriasis ho tloha ka 2004 le ho phekola bana ba nang le ramatiki ea bana ba nang le bokooa (JIA) ho tloha ka 1999.

Moriana ona o nang le ente o sebetsa ka ho fokotsa ts'ebetso ea TNF-alpha.

Phuputso ea 2016 ea bana ba ka bang 70 ba lilemo li 4 ho isa ho 17 e fumane hore Enbrel o bolokehile mme o lula a sebetsa ho fihlela lilemo tse 5.

Beke e 'ngoe le e' ngoe, bana le bacha ba fumana 0.8 mg ea lithethefatsi ka kilogram ea boima ba 'mele ea bona. Tekanyo e phahameng eo ngaka ea bona e tla fana ka eona ke 50 mg ka beke, e leng tekanyetso e tloaelehileng bakeng sa batho ba baholo.

Litla-morao tse tloaelehileng ke litlamorao setsing sa ente le tšoaetsong e kaholimo ea phefumoloho.

Litlhare tse ling li haufi le ho amoheloa

Lithethefatsi tse ling li atametse tumello ea FDA.

Bimekizumab

Bimekizumab ke moriana o nang le ente oa biologic o ntseng o lekoa e le kalafo ea psoriasis ea plaque e sa foleng. E sebetsa ka ho thibela IL-17.

Bimekizumab hajoale o lithutong tsa mokhahlelo oa III. Ho fihlela joale, lipatlisiso li bontšitse hore e bolokehile ebile e sebetsa.

Tekong ea BE SURE ea liteko tsa bongaka, bimekizumab e ne e sebetsa hantle ho feta adalimumab (Humira) ho thusa batho ho fumana bonyane ntlafatso ea liperesente tse 90 lipalo tse sebelisetsoang ho lekanya ho tiea ha mafu.

Setlolo sa calcipotriene-betamethasone dipropionate, 0.005% / 0.064% (Wynzora)

Ho 2019, kopo e ncha ea lithethefatsi e ile ea tlisoa ho FDA bakeng sa Wynzora. Wynzora ke tranelate ea hanngoe ka letsatsi e kopanyang calcipotriene le betamethasone dipropionate.

Thutong ea karolo ea III, Wynzora o ne a atleha ho hlatsoa letlalo kamora libeke tse 8 ho feta ho emisoa ha Taclonex ka lihlooho le tranelate.

Wynzora e na le monyetla oa ho se nrereasy, eo barupeluoa ba boithuto ba e fumaneng e le bonolo haholoanyane.

JAK inhibitors

JAK inhibitors ke sehlopha se seng sa lithethefatsi tse fetolang mafu. Ba sebetsa ka ho lebisa tlhokomelo litseleng tse thusang 'mele ho etsa liprotheine tse ngata tse ruruhang.

Li se li sebelisetsoa ho phekola:

• psoriatic ramatiki
• ramatiki ea ramatiki
• ulcerative colitis

Ba 'maloa ba maemong a karolo ea II le ea III bakeng sa psoriasis e mahareng le e matla. Tse ithutiloeng bakeng sa psoriasis ke lithethefatsi tsa molomo tofacitinib (Xeljanz), baricitinib (Olumiant), le abrocitinib. Setsi sa lihlooho tsa JAK inhibitor le sona se ntse se phenyekolloa.

Ho fihlela hajoale, liphuputso li fumane hore JAK inhibitors e sebetsa hantle bakeng sa psoriasis. Li batla li sireletsehile joalo ka litlhare tse teng tsa biologic. Molemo o mong ke hore li tla ka sebopeho sa lipilisi 'me ha lia lokela ho fuoa liente.

Liphuputso tse entsoeng ho fihlela joale e bile tsa nakoana. Ho hlokahala lipatlisiso tse ling ho tseba hore na li-inhibitors tsa JAK li ntse li tsoela pele ho sebetsa nako e telele.

Tsa Tsau-tsau

Ho lula u tseba ka likhetho tse ncha ka ho fetisisa tsa ho phekola psoriasis ho bohlokoa ho laola maemo a hau.

Ha ho na kalafo e lekanang boholo ba psoriasis. Ho ka etsahala hore o tla tlameha ho leka mekhoa e mengata ea kalafo pele o fumana e u sebeletsang hantle ebile e sa bake litlamorao.

Litšibollo tse ncha tsa psoriasis li etsahala ka linako tsohle. Etsa bonnete ba hore o buisana le ngaka ea hau ka likhetho tse ncha tsa kalafo.