Patlisiso ea Bokamoso le Liteko tsa Kliniki bakeng sa Progressive MS ea Mathomo

Litaba

• Kakaretso
• Mefuta ea MS
• Ho utloisisa MS ea mantlha e tsoelang pele
• Phekolo ea PPMS
• Ocrevus (Ocrelizumab)
• Liteko tsa bongaka tsa PPMS tse ntseng li tsoela pele
• Phekolo ea cell cell ea NurOwn
• Biotin
• Masitinib
• Liteko tsa kliniki tse phethetsoeng
• Ibudilast
• Idebenone
• Laquinimod
• Fampridine
• Patlisiso ea PPMS
• Tsela

Kakaretso

Multiple sclerosis (MS) ke boemo bo sa foleng ba ho itšireletsa mafung. E etsahala ha 'mele o qala ho hlasela likarolo tsa sistimi ea methapo e bohareng (CNS).

Bongata ba meriana ea morao-rao le kalafo li shebane le ho khutla hape ha MS eseng ho MS (PPMS) ea mantlha. Leha ho le joalo, liteko tsa bongaka li lula li ts'oaroa ho thusa ho utloisisa hamolemo PPMS le ho fumana litlhare tse ncha tse sebetsang.

Mefuta ea MS

Mefuta e mene e meholo ea MS ke:

• lefu le thoko la bongaka (CIS)
• ho khutla hape ka MS (RRMS)
• MS e tsoelang pele ea mantlha (PPMS)
• MS-SPMS e tsoelang pele

Mefuta ena ea MS e thehiloe ho thusa bafuputsi ba bongaka ho arola barupeluoa ba liteko tsa bongaka ka nts'etsopele e tšoanang ea mafu. Lihlopha tsena li lumella bafuputsi ho lekola katleho le polokeho ea kalafo e itseng ntle le ho sebelisa palo e kholo ea bankakarolo.

Ho utloisisa MS ea mantlha e tsoelang pele

Ke liperesente tse 15 feela kapa batho bohle ba fumanoeng ba na le MS ba nang le PPMS. PPMS e ama banna le basali ka ho lekana, athe RRMS e atile haholo ho basali ho feta banna.

Mefuta e mengata ea MS e etsahala ha sesole sa 'mele se hlasela myelin sheath. Sekhahla sa myelin ke ntho e mafura, e sirelletsang e potileng methapo mokokotlong le bokong. Ha ntho ena e hlaseloa, e baka ho ruruha.

PPMS e lebisa tšenyo ea methapo le lisele tse bohale libakeng tse senyehileng. Lefu lena le sitisa ts'ebetso ea puisano ea methapo, le baka matšoao a sa lebelloang le kholo ea mafu.

Ho fapana le batho ba nang le RRMS, batho ba nang le boiphihlelo ba PPMS ba ntse ba mpefala butle butle ntle le ho khutlela morao kapa ho ts'oaroa. Ntle le keketseho e holofalang butle-butle, batho ba nang le PPMS le bona ba ka ba le matšoao a latelang:

• kutlo ya ho hatsela kapa ho tsitsinyeha
• mokgathala
• bothata ba ho tsamaea kapa ho tsamaisa mekhatlo
• e na le pono, joalo ka pono e habeli
• mathata a ho hopola le ho ithuta
• mesifa kapa ho thatafala hoa mesifa
• liphetoho maikutlong

Phekolo ea PPMS

Ho phekola PPMS ho thata ho feta ho phekola RRMS, mme ho kenyelletsa ts'ebeliso ea litlhare tsa immunosuppressive. Litlhare tsena li fana ka thuso ea nakoana feela. Li ka sebelisoa feela ka polokeho le khafetsa ka likhoeli tse 'maloa ho isa ho selemo ka nako.

Le ha Tsamaiso ea Lijo le Lithethefatsi (FDA) e amohetse meriana e mengata bakeng sa RRMS, ha se tsohle tse loketseng mefuta e tsoelang pele ea MS. Meriana ea RRMS, eo hape e tsejoang e le lithethefatsi tse fetolang mafu (DMDs), e nkuoa e sa khaotse mme hangata e na le litla-morao tse sa mamelleheng.

Ho felisa liso le mafolofolo a methapo ho ka fumanoa ho batho ba nang le PPMS. Lisosa li ruruha haholo 'me li ka baka tšenyo selateng sa myelin. Hona joale ha ho tsejoe hantle hore na meriana e fokotsang ho ruruha e ka liehisa mefuta e tsoelang pele ea MS.

Ocrevus (Ocrelizumab)

FDA e amohetse Ocrevus (ocrelizumab) joalo ka kalafo ea RRMS le PPMS ka Hlakubele 2017. Ho fihlela joale, ke setlhare feela se amohetsoeng ke FDA ho phekola PPMS.

Liteko tsa bongaka li bontšitse hore e khona ho liehisa kholo ea matšoao ho PPMS ka liperesente tse 25 ha e bapisoa le placebo.

Ocrevus e boetse e amoheloa bakeng sa kalafo ea RRMS le "pele" PPMS England. Ha e so amoheloe likarolong tse ling tsa United Kingdom.

Setsi sa Naha sa Bophelo bo Botle ba Bophelo (NICE) qalong se ile sa hana Ocrevus ka lebaka la hore litšenyehelo tsa ho e fana li feta melemo ea eona. Leha ho le joalo, NICE, National Health Service (NHS), le moetsi oa lithethefatsi (Roche) qetellong ba ile ba buisana hape ka theko ea eona.

Liteko tsa bongaka tsa PPMS tse ntseng li tsoela pele

Taba ea mantlha ho bafuputsi ke ho ithuta haholoanyane ka mefuta e tsoelang pele ea MS. Lithethefatsi tse ncha li tlameha ho feta litekong tse matla tsa bongaka pele FDA e li amohela.

Liteko tse ngata tsa bongaka li nka lilemo tse 2 ho isa ho tse tharo. Leha ho le joalo, hobane lipatlisiso li na le moeli, ho hlokahala liteko tse telele ho feta bakeng sa PPMS. Liteko tse ling tsa RRMS li ntse li khannoa hobane ho bonolo ho ahlola katleho ea meriana ho oeng hape.

Sheba webosaete ea National Multiple Sclerosis Society bakeng sa lenane le felletseng la liteko tsa bongaka United States.

Liteko tse latelang tse khethiloeng li ntse li tsoela pele.

Phekolo ea cell cell ea NurOwn

Brainstorm Cell Therapeutics e etsa teko ea bongaka ea karolo ea II ho etsa lipatlisiso tsa polokeho le katleho ea lisele tsa NurOwn kalafong ea MS e tsoelang pele. Kalafo ena e sebelisa lisele tsa bakoang tse nkiloeng ho bankakarolo tse hlohlellelitsoeng ho hlahisa lintlha tse itseng tsa kholo.

Ka Pherekhong 2019, National Multiple Sclerosis Society e file Brainstorm Cell Therapeutics thuso ea lipatlisiso ea $ 495,330 ho ts'ehetsa kalafo ena.

Nyeoe e lebelletsoe ho phetheloa ka Loetse 2020.

Biotin

MedDay Pharmaceuticals SA hajoale e ntse e etsa liteko tsa bongaka tsa mokhahlelo oa III mabapi le katleho ea lethal dose ea biotin capsule ho phekola batho ba nang le MS e tsoelang pele. Nyeoe e boetse e ikemiselitse ho shebana ka kotloloho le batho ba nang le mathata a gait.

Biotin ke vithamine e amehang ho susumetseng lisosa tsa kholo ea lisele hammoho le tlhahiso ea myelin. Capsule ea biotin e bapisoa le placebo.

Nyeoe ha e sa hira bankakarolo ba bacha, empa ha ea lebelloa ho phetheloa ho fihlela ka Phuptjane 2023.

Masitinib

Saense ea AB e etsa liteko tsa bongaka tsa mokhahlelo oa III ho masitinib ea lithethefatsi. Masitinib ke sethethefatsi se thibelang karabelo ea ho ruruha. Sena se lebisa karabong e tlase ea boits'ireletso ba mmele le maemong a tlase a ho ruruha.

Nyeoe e lekola polokeho le katleho ea masitinib ha e bapisoa le placebo. Mefuta e 'meli ea kalafo ea masitinib e bapisoa le placebo: Mokhahlelo oa pele o sebelisa litekanyo tse tšoanang hohle, ha e' ngoe e kenyelletsa ho nyoloha ha litekanyetso kamora likhoeli tse tharo.

Nyeoe ha e sa hira bankakarolo ba bacha. Ho lebelletsoe ho phethela ka Loetse 2020.

Liteko tsa kliniki tse phethetsoeng

Liteko tse latelang li sa tsoa phetheloa. Bakeng sa boholo ba bona, ho phatlalalitsoe liphetho tsa pele kapa tsa hoqetela.

Ibudilast

MediciNova o phethile teko ea bongaka ea mokhahlelo oa II ho ibudilast ea lithethefatsi. Morero oa eona e ne e le ho tseba polokeho le tšebetso ea lithethefatsi ho batho ba nang le MS e tsoelang pele. Thutong ena, ibudilast e ile ea tšoantšoa le "placebo".

Liphetho tsa pele tsa boithuto li bonts'a hore ibudilast e liehisitse kholo ea boko ba 'mele ha e bapisoa le placebo nakong ea libeke tse 96. Litla-morao tse tloaelehileng haholo tse tlalehiloeng e ne e le matšoao a mala.

Leha liphetho li ts'episa, liteko tse ling lia hlokahala ho bona hore na liphetho tsa teko ena li ka hlahisoa bocha le hore na ibudilast e ka bapisoa joang le Ocrevus le lithethefatsi tse ling.

Idebenone

Setsi sa Naha sa Ts'oaetso ea Maloetse le Mafu a tšoaetsanoang (NIAID) haufinyane se phethile teko ea bongaka ea karolo ea I / II ho lekola phello ea idebenone ho batho ba nang le PPMS. Idebenone ke mofuta oa maiketsetso oa coenzyme Q10. Ho lumeloa hore e fokotsa tšenyo tsamaisong ea methapo.

Ho theosa le lilemo tsa ho qetela tsa 2 tsa teko ena ea lilemo tse 3, bankakarolo ba nkile sethethefatsi kapa placebo. Liphetho tsa pele li bontšitse hore, nakong ea boithuto, idebenone ha e fane ka molemo ho feta placebo.

Laquinimod

Liindasteri tsa Teva Pharmaceutical li tšehelitse thuto ea karolo ea II molemong oa ho theha bopaki ba mohopolo oa ho phekola PPMS ka laquinimod.

Ha ho utloisisoe ka botlalo hore na laquinimod e sebetsa joang. Ho lumeloa hore e fetola boits'oaro ba lisele tsa 'mele, ka hona ho thibela tšenyo ea sistimi ea methapo.

Liphetho tse nyahamisang tsa liteko li entse hore moetsi oa eona, Active Biotech, a khaotse ho hlahisa laquinimod e le sethethefatsi sa MS.

Fampridine

Ka 2018, University College Dublin e phethile teko ea karolo ea IV ho hlahloba phello ea fampridine ho batho ba nang le ho se sebetse hantle ha maoto le matsoho kapa PPMS kapa SPMS. Fampridine e boetse e tsejoa e le dalfampridine.

Le ha nyeoe ena e phethetsoe, ha ho liphetho tse tlalehiloeng.

Leha ho le joalo, ho latela phuputso ea Setaliana ea 2019, sethethefatsi sena se ka ntlafatsa lebelo la ts'ebetso ea tlhahisoleseling ho batho ba nang le MS. Tlhahlobo ea 2019 le tlhatlhobo ea meta e phethile ka hore ho na le bopaki bo matla ba hore moriana o ntlafalitse bokhoni ba batho ba nang le MS ba tsamaeang sebaka se sekhutšoane le matla a bona a ho tsamaea.

Patlisiso ea PPMS

National Multiple Sclerosis Society e khothaletsa lipatlisiso tse tsoelang pele ka mefuta e tsoelang pele ea MS. Morero ke ho theha kalafo e atlehileng.

Liphuputso tse ling li shebile phapang lipakeng tsa batho ba nang le PPMS le batho ba phetseng hantle. Phuputso ea morao-rao e fumane hore lisele tsa methapo bokong ba batho ba nang le PPMS li shebahala li le kholo ho feta lisele tse tšoanang tsa bakoang ho batho ba phetseng hantle ba lilemo tse tšoanang.

Ntle le moo, bafuputsi ba fumane hore ha li-oligodendrocyte, lisele tse hlahisang myelin, li pepesetsoa lisele tsena tsa bakoang, li hlahisitse liprotheine tse fapaneng ho fapana le tsa batho ba phetseng hantle. Ha polelo ena ea protheine e koetsoe, li-oligodendrocyte li itšoere hantle. Sena se ka thusa ho hlalosa hore na hobaneng myelin e sekiselitsoe ho batho ba nang le PPMS.

Phuputso e 'ngoe e fumane hore batho ba nang le MS e tsoelang pele ba na le limolek'hule tse tlase tse bitsoang bile acid. Bile acid e na le mesebetsi e mengata, haholo ts'ebetsong. Li boetse li na le phello e khahlanong le ho ruruha liseleng tse ling.

Li-receptor tsa li-bile acid le tsona li fumanoe liseleng tsa lisele tsa MS. Ho nahanoa hore tlatsetso ka bile acid e ka thusa batho ba nang le MS e tsoelang pele. Ebile, teko ea bongaka ea ho leka sena hantle e ntse e tsoela pele.

Tsela

Lipetlele, liunivesithi le mekhatlo e meng hohle United States li ntse li sebeletsa ho tsoela pele ho ithuta haholoanyane ka PPMS le MS ka kakaretso.

Ho fihlela hajoale ke sethethefatsi se le seng feela, Ocrevus, se amoheloang ke FDA bakeng sa kalafo ea PPMS. Ha Ocrevus a liehisa tsoelo-pele ea PPMS, ha e emise tsoelo-pele.

Lithethefatsi tse ling, joalo ka ibudilast, li bonahala li ts'episa ho latela liteko tsa pele. Lithethefatsi tse ling, tse kang idebenone le laquinimod, ha lia bontšoa hore lia sebetsa.

Liteko tse ling lia hlokahala ho khetholla litlhare tse ling tsa PPMS. Botsa mofani oa tlhokomelo ea bophelo mabapi le liteko tsa morao-rao tsa bongaka le lipatlisiso tse ka u tsoelang molemo.