UGALVUS (VILDAGLIPTIN). IZIBHEBHE ZESIFO SIKASHUKELA I-GALVUS MET - I-VILDAGLIPTIN ENE-METFORMIN

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UGalvus umuthi wesifo sikashukela, into esebenzayo yi-vildagliptin, eqenjini le-DPP-4 inhibitors. Amacwecwe esifo sikashukela seGalvus abhaliswe eRussia kusukela ngo-2009. Zikhiqizwa nguNovartis Pharma (Switzerland).

Izibhebhe zeGalvus zesifo sikashukela eqenjini lama-inhibitors e-DPP-4 - into esebenzayo iVildagliptin

UGalvus ubhaliselwe ukwelashwa kweziguli ezinesifo sikashukela sohlobo 2. Ingasetshenziswa njengomuthi okuwukuphela kwawo, futhi umphumela wawo uzohambisana nomphumela wokudla nokuzivocavoca. Amaphilisi wesifo sikashukela we-Galvus futhi angasetshenziswa ngokuhambisana ne:

metformin (siofor, glucophage);
okususelwa ku-sulfonylurea (ungakwenzi lokhu!);
thiazolinediones;
insulin

Khipha ifomu

Ifomu lezemithi uGalvus (vildagliptin) - amaphilisi angu-50 mg.

Umthamo wethebhulethi kaGalvus

Umthamo ojwayelekile weGalvus njenge-monotherapy noma ngokubambisana ne-metformin, i-thiazolinediones noma i-insulin - amahlandla ama-2 ngosuku, ama-50 mg, ekuseni nakusihlwa, noma ngabe uthathwa kanjani ukudla. Uma isiguli sinqunywa umthamo wethebhulethi eyi-1 ka-50 mg ngosuku, khona-ke kufanele uphuzwe ekuseni.

I-Vildagliptin - into esebenzayo yesidakamizwa sikashukela u-Galvus - ichazwa yizinso, kepha inesimo semetabolites engasebenzi. Ngakho-ke, esigabeni sokuqala sokuhluleka kwe-renal, umthamo wesidakamizwa awudingeki ukuthi uguqulwe.

Uma kukhona ukwephulwa okunzima kokusebenza kwesibindi (i-ALT noma i-AST enzymes ephindwe izikhathi ezingama-2,5 kunomkhawulo ophezulu wejwayelekile), khona-ke uGalvus kufanele anqunywe ngokuqapha. Uma isiguli sakha i-jaundice noma ezinye izikhalazo zesibindi zivela, ukwelashwa kwe-vildagliptin kufanele kumiswe ngokushesha.

Kwabashukela abanesifo sikashukela abaneminyaka engu-65 nangaphezulu - umthamo kaGalvus awuguquki uma kungekho dokotela ofanayo. Akukho datha ekusetshenzisweni kwalo muthi wesifo sikashukela ezinganeni nakwintsha eneminyaka engaphansi kwengu-18. Ngakho-ke, akunconywa ukuyinikeza iziguli zaleli qembu leminyaka.

Umphumela wehlisela ushukela i-vildagliptin

Umphumela wehlise ushukela we-vildagliptin wafundwa eqenjini leziguli ezingama-354. Kwavela ukuthi i-galvus monotherapy kungakapheli amasonto angama-24 kuholele ekunciphiseni okukhulu kwe-glucose egazini kulezi ziguli ezazingazange zilaphe uhlobo lwazo lwesifo sikashukela. Inkomba yabo ye-hemoglobin ye-glycated yehle ngo-0,4-0.8%, naseqenjini le-placebo - ngo-0,1%.

Olunye ucwaningo luqhathanise imiphumela ye-vildagliptin ne-metformin, umuthi wesifo sikashukela owaziwa kakhulu (siofor, glucophage). Lolu cwaningo luphinde lwabandakanya iziguli ezazisanda kutholakala ukuthi zinesifo sikashukela sohlobo 2, ezazingakaze zelashwe ngaphambilini.

Kwavela ukuthi i-galvus kuzinkomba eziningi zokusebenza ayiphansi kune-metformin. Ngemuva kwamaviki angama-52 (unyaka ongu-1 wokwelashwa) ezigulini ezithatha i-galvus, izinga le-hemoglobin ye-glycated lehle ngesilinganiso se-1,0%. Eqenjini le-metformin, lehle ngo-1.4%. Ngemuva kweminyaka engu-2, izinamba zahlala zifana.

Ngemuva kwamasonto angama-52 wokuthatha amaphilisi, kwavela ukuthi amandla esisindo somzimba ezigulini emaqenjini e-vildagliptin ne-metformin acishe afane.

UGalvus ubekezelelwa kangcono yiziguli kune-metformin (Siofor). Imiphumela emibi evela emgodini wesisu ikhula kancane kakhulu. Ngakho-ke, ama-algorithms wesimanje anikezwe ngokusemthethweni ukwelashwa kwesifo sikashukela sohlobo 2 kukuvumela ukuthi uqale ukwelashwa nge-galvus, kanye ne-metformin.

IGalvus Met: i-vildagliptin + inhlanganisela ye-metformin

IGalvus Met ngomuthi wokuhlanganisa, ithebhulethi engu-1 yayo iqukethe i-vildagliptin ngethamo lika-50 mg ne-metformin ngemithamo ye-500, 850 noma i-1000 mg. Bhaliswa eRussia ngoMashi 2009. Kunconywa ukunquma iziguli 1 ithebhulethi 2 ngosuku.

IGalvus Met umuthi wokuhlanganisa isifo sikashukela sohlobo 2. Siqukethe i-vildagliptin ne-metformin. Izithako ezimbili ezisebenzayo kuthebhulethi eyodwa - kulula ukuyisebenzisa futhi ziyasebenza.

Ukuhlanganiswa kwe-vildagliptin ne-metformin kuqashelwa njengokufanele ekwelashweni kwesifo sikashukela sohlobo 2 ezigulini ezingathathi i-metformin zodwa. Izinzuzo zako:

umphumela wokwehla kwamazinga kashukela egazini uyanda, uma uqhathanisa ne-monotherapy nanoma iyiphi enye yezidakamizwa;
umsebenzi osele wamaseli we-beta ekwakhiweni kwe-insulin uyagcinwa;
isisindo somzimba weziguli asikhuphuki;
ubungozi be-hypoglycemia, kufaka phakathi obukhali, abukhuphuki;
imvamisa yemiphumela emibi ye-metformin evela emgodini wesisu - ihlala isezingeni elifanayo, ayikhuphuki.

Ucwaningo lufakazele ukuthi ukuthatha i-Galvus Met kusebenza kahle njengokuthatha amaphilisi amabili ahlukile nge-metformin ne-vildagliptin. Kepha uma udinga ukuthatha ithebhulethi elilodwa kuphela, kulapho-ke kusebenza futhi ukwelashwa kusebenza kakhulu. Ngoba mancane amathuba okuba isiguli sakhohlwe noma sidide okuthile.

Kwenziwe ucwaningo - qhathanisa ukwelashwa kwesifo sikashukela noGalvus Met nolunye uhlelo olujwayelekile: metformin + sulfonylureas. Ama-Sulfonylureas anqunyelwe iziguli ezinesifo sikashukela ezathola ukuthi iMetformin iyodwa ayanele.

Ucwaningo lwalulukhulu. Iziguli ezingaphezu kwe-1300 kuwo womabili amaqembu zabamba iqhaza kukho. Isikhathi - unyaka ongu-1. Kwavela ukuthi ezigulini ezithatha i-vildagliptin (izikhathi ezingama-50 mg ngosuku) nge-metformin, amazinga kashukela egazi ayehla kanye nalabo abathatha i-glimepiride (6 mg 1 isikhathi ngosuku).

Kwakungekho mehluko omkhulu emiphumeleni yokwehlisa ushukela wegazi. Ngesikhathi esifanayo, iziguli eziseqenjini lezidakamizwa leGalvus Met zathola i-hypoglycemia izikhathi eziyi-10 kaningi kunalezo eziphathwa nge-glimepiride ene-metformin. Azange kube namacala e-hypoglycemia enkulu ezigulini ezithatha i-Galvus Met unyaka wonke.

Asetshenziswa Kanjani Amaphilisi Sikashukela Ashukela Ne-Insulin

UGalvus wayengumuthi wokuqala wesifo sikashukela eqenjini le-DPP-4, elibhaliselwe ukusetshenziswa okuhlangene ne-insulin. Njengomthetho, kunqunywa uma kungenakwenzeka ukulawula kahle isifo sikashukela 2 ngokwelashwa kwe-basal kuphela, okungukuthi, i-insulin “ende”.

Ucwaningo lwe-2007 lwahlola ukusebenza nokuphepha kokufaka i-galvus (izikhathi ezingama-50 mg ngosuku ngosuku) ngokumelene ne-placebo. Iziguli zabamba iqhaza ezazihlala emazingeni aphezulu we-glycated hemoglobin (7.5-11%) ngokumelene nemijovo ye- "average" insulin ene-Hagedorn protramine (NPH) engathathwanga kumthamo wamayunithi angaphezu kwama-30 / ngosuku.

Iziguli eziyi-144 zithole i-galvus kanye nemijovo ye-insulin, iziguli eziyi-152 ezinesifo sikashukela sohlobo lwe-2 zathola i-placebo ngemuva kwemijovo ye-insulin. Eqenjini le-vildagliptin, izinga eliphakathi le-hemoglobin ye-glycated lehle kakhulu ngo-0,5%. Eqenjini le-placebo, ngo-0,2%. Ezigulini ezineminyaka engaphezu kwengu-65, izinkomba zingcono kakhulu - ukwehla kwe-0.7% ngemuva kwe-galvus ne-0.1% ngenxa yokuthatha i-placebo.

Ngemuva kokungeza i-galvus ku-insulin, ubungozi be-hypoglycemia bancipha kakhulu, uma kuqhathaniswa nokwelashwa kwesifo sikashukela, imijovo kuphela ye- "average" NPH-insulin. Eqenjini le-vildagliptin, inani eliphelele leziqephu ze-hypoglycemia laliyi-113, eqenjini le-placebo - 185. Ngaphezu kwalokho, alikho icala elilodwa le-hypoglycemia eliqaphelekile ngemuva kwesizinda sokwelashwa kwe-vildagliptin. Kwakukhona iziqephu ezi-6 ezinjalo eqenjini le-placebo.

Imiphumela emibi

Ngokuvamile, i-galvus isidakamizwa esivikeleke kakhulu. Ucwaningo luqinisekisa ukuthi ukwelashwa kwesifo sikashukela sohlobo 2 nalo muthi awukhuphi ubungozi besifo senhliziyo, izinkinga zesibindi, noma amaphutha amasosha omzimba. Ukuthatha i-vildagliptin (isithako esisebenzayo kumathebhulethi e-galvus) asikhulisi isisindo somzimba.

Uma kuqhathaniswa nama-ejenti okwehlisa ushukela egazini, kanye ne-placebo, i-galvus ayikhulisi ubungozi be-pancreatitis. Iningi lemiphumela yayo emibi imnene futhi ingeyesikhashana. Akuvamile ukubonwa: