Gilenya

Gilenya (Φιγκολιμόδη)

bbkGilenyaMOAΤο Gilenya με την κυκλοφορία του τον Αυγουστο του 2011, αποτέλεσε μια επανάσταση στη θεραπευτική της Πολλαπλής Σκλήρυνσης κι ένα ισχυρό όπλο στα χέρια των ιατρών.

Ο μηχανισμός δράσης του είναι πολύ πολύπλοκος και εν πολλοίς, άγνωστος. Δίπλα βλέπετε την πιό απλουστευμένη του μορφή. Σ’ αυτήν αναδεικνύεται το βασικό χαρακτηριστικό του φαρμάκου, δηλαδή ότι δεν μειώνει τα συνολικά λεμφοκύτταρα του οργανισμού. Μειώνει μόνο αυτά που κυκλοφορούν στο αίμα ενώ τα άλλα τα “δεσμεύει” μέσα στο λεμφικό όργανο τροποποιώντας κάποιους υποδοχείς.

Το Gilenya, συγκρινόμενο με τα υπάρχοντα “φάρμακα πρώτης γραμμής” (μέχρι τότε ήσαν οι ιντερφερόνες και η γκλατιραμέρη) έδειξε μεγαλύτερη αποτελεσματικότητα. Εδειξε ότι έχει αποτέλεσμα στην εξέλιξη της αναπηρίας του ασθενούς αλλά και καλύτερη αποτελεσματικότητα από τα φάρμακα πρώτης γραμμής στη μείωση του αριθμού τών ώσεων. Τέλος το Gilenya φάνηκε ότι μειώνει και το ρυθμό εξέλιξης της εγκεφαλικής ατροφίας σε σύγκριση με τις ιντερφερόνες…(Μετάφραση: doctorbabis)Fingolimod (FTY720): discovery and development of an oral drug to treat multiple sclerosis.
Brinkmann V1, Billich A, Baumruker T, Heining P, Schmouder R, Francis G, Aradhye S, Burtin P.

Ενας από τους λόγους που bbk-gilenyaCapsτο Gilenya αποτέλεσε επανάσταση στη θεραπευτική της Πολλαπλής Σκλήρυνσης όταν κυκλοφόρησε ήταν ότι επρόκειτο για το πρώτο φάρμακο για την Πολλαπλή Σκλήρυνση που το έπαιρνε ο ασθενής από το στόμα. Κυκλοφόρησε με το “μοτό”: “Μία κάψουλα, μία φορά την ημέρα”.

Κυκλοφορεί σε κάψουλες των 0,5mg και τη δοσολογία όπως και τη συχνότητα λήψης πάντα την καθορίζει ο θεράπων ιατρός, αφού το επιλέξει με συγκεκριμένα κριτήρια.

 

Ποιές εξετάσεις πρέπει να γίνουν πρίν την έναρξη θεραπείας με Gilenya

Καρδιολογικός έλεγχος

Επειδή στην αρχή της θεραπείας μπορεί να παρατηρηθεί βραδυκαρδία, δηλαδή μείωση του καρδιακού ρυθμού, είναι απαραίτητος ένας προληπτικός έλεγχος για ήδη υπάρχουσες ανωμαλίες του καρδιακού ρυθμού.

Μετά την χορήγηση του πρώτου χαπιού ο ασθενής παραμένει επί 6 ώρες στο Νοσοκομείο για την παρακολούθηση του καρδιακού ρυθμού 

Ελεγχος για σοβαρή ενεργό λοίμωξη
Η χρήση του Gilenya μπορεί να μειώσει την αμυντική ικανότητα του οργανισμού απέναντι σε ιούς και μικρόβια. Καθυστερήστε την έναρξη θεραπείας
Ελεγχος αντισωμάτων ανεμοβλογιάς-Ερπητα Ζωστήρα (VZV)

Εάν η εξέταση είναι αρνητική εξετάστε το ενδεχόμενοεμβολιασμού και καθυστερήστε την έναρξη θεραπείας

Μέτρηση των λευκών αιμοσφαιρίων του αίματος

Η εξέταση αυτή πρέπει να επαναλαμβάνεται και σε τακτά χρονικά διαστήματα κατά τη διάρκεια της θεραπείας.

Σε περίπτωση επιβεβαιωμένης μείωσης του απόλυτου αριθμού των λεμφοκυττάρων κάτω από τα 200/μL, πρέπει να διακόψουμε άμεσα το φάρμακο, μέχρι την επαναφορά τους στο φυσιολογικό (αυτή η πρακτική εφαρμοστηκε και στις κλινικές μελέτες)

Τέστ εγκυμοσύνης

Πρέπει να είναι αρνητικό

Σε διαβητικούς ασθενείς: προληπτικός οφθαλμολογικός έλεγχος

Για ραγοειδίτιδα

 

Τί πρέπει να προσέχουν όσοι κάνουν θεραπεία με Gilenya

  • Την εμφάνιση οποιασδήποτε διαταραχής από την όρασή τους
  • Την εμφάνιση λοιμώξεων
  • Την μείωση των λεμφοκυττάρων κάτω από τα 200/μL
  • Την ηπατική λειτουργία με τη μέτρηση των τρανσαμινασών

Άν συμβεί οτιδήποτε από τα παραπάνω, πρέπει να ενημερώνεται άμεσα ο θεράπων ιατρός.

 

ΔΕΝ συνιστάται η χρήση του Gilenya σε:
  • Περιόδους γαλουχίας ή εγκυμοσύνης.
  • Σε βαριά ηπατική ανεπάρκεια.
  • Σε σακχαρώδη διαβήτη.

 

Να θυμάστε πάντα: Μήν παίρνετε ή μή διακόπτετε ποτέ κάποιο φάρμακο, χωρίς την οδηγία του γιατρού σας.Χαράλαμπος Καραγιαννίδης, Νευρολόγος-Ψυχίατρος

Άλλα φάρμακα για την πολλαπλή σκλήρυνση

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