ʻO ka rumatika inflammative, e like me ka rheumatoid arthritis, akā ʻo ka ankylosing spondylitis, ka maʻi ʻōpio ʻōpio a i ʻole ka psoriatic arthritis, e pili ana i nā tausani mau kānaka ma Palani. Ke kumu o ka ʻeha a me ke kino kīnā o ka hana me ka luku pū ʻia, hiki i kēia rumatika ke loaʻa nā hopena koʻikoʻi. Ua mālama mua ʻia me nā lāʻau wale nō ma ke ʻano he lāʻau maʻamau, ua hōʻea mai nā biotherapies i kēia manawa, e ʻae ana i ka hoʻokele pilikino ʻana o kēia pathology.

Hoʻolālā ʻia nā biotherapies e hoʻohana ana i nā meaola ola, i ʻike ʻia e ka ʻenekini genetika. Pēlā i ʻike ai nā kānaka noiʻi he cytokine (protein o ka ʻōnaehana paleʻea), TNF-alpha, ka mea e hana i nā hana hoʻomeamea. Pēlā kēia mau biotherapies i kāohi ai i kāna hana, e nā ʻano hana ʻelua:

• ke kāohi nei i nā antibodies monoclonal TNF alpha;
• he receptor soluble e hana ma ke ʻano he hoʻopunipuni a hoʻopaʻa i kēia TNF.

I kēia lā, aia he ʻelua mau pale ʻaoʻao a he receptor soluble i loaʻa ma ka mākeke.

I ke alo o nā maʻi kuni, ua holomua ka lāʻau i loko o ke kenekulia i hala.

• i mālama mua ʻia me ka aspirin i ka hoʻomaka ʻana o ke kenekulia 20, ua hoʻoliʻiliʻi wale ʻia nā maʻi ʻōpala, ʻoiai nā hopena i makemake ʻole ʻia o ka aspirin;
• i nā makahiki 1950, ua hōʻea ʻo Cortisone i ka hōʻola i ka mālama ʻana i ke kaʻina hana hoʻomeamea. Me nā hopena e pili koke ana i ka mumū, akā naʻe, ʻaʻole ia e hoʻokū i ka maʻi, a he nui nā hopena ʻaoʻao hōʻoluʻolu ʻole;
• a laila, i nā makahiki 1970, ʻo ia ka hoʻomohala ʻana o ke kīpē orthopedic i hiki ai ke mālama i ka poʻe me ka rumatika inflammative, e ka hana pololei ʻana i nā hono luku pinepine ʻia;
• ʻo nā lāʻau lapaʻau mua mua i hōʻea i nā makahiki 1980: methotrexate, ka lāʻau like i kuhikuhi ʻia i ka oncology akā i ka hoʻemi ʻia ʻana, ua maikaʻi a ʻae ʻia e ka hapa nui o nā maʻi. Ua kuhi hewa ʻia e hoʻohana wale ʻia kēia lapaʻau ma ke ʻano he hopena hope loa; akā ua hōʻino ke ʻano o nā hono i kēia nalo ʻana o ka manawa, pinepine i nā makahiki ʻelua mua. I kēia lā, hoʻopili koke ʻia kēia lapaʻau, i nā hōʻailona mua o ka maʻi, i mea e mālama ai i nā hono. Loaʻa ka maikaʻi o kēia mau lāʻau lapaʻau no ka inexpensive: ma kahi o 80 euro i kēlā me kēia mahina no ka methotrexate, ka mea pono loa o lākou, a maikaʻi i ka hapakolu o nā maʻi me ka rheumatoid arthritis;
• Mai ka hopena o nā 1990s, ua ulu nui ka mālama ʻana o ka lāʻau i kēia mau maʻi me ka puka ʻana o nā biotherapies e kuhikuhi ana i nā hana hoʻomeamea, a manaʻo ʻia e ʻoi aku ka maikaʻi. I kēia manawa he ʻumikūmālima ka nui, 100% lākou e uhi ʻia e ka ʻInikua Ola.

I loko nō o nā kamepiula i hoʻomālamalama ʻia, ua hoʻokumu paʻa ʻia nā pono o nā biotherapies.

ʻOiai ʻo 20 a 30% o nā mea maʻi ʻaʻole i hōʻoluʻolu ʻia e ka lāʻau lapaʻau i manaʻo ʻia ʻo ia ka mea maikaʻi loa (methotrexate), ʻike ʻia he 70% o nā mea maʻi e pane maikaʻi i ka mālama ʻana me ka biotherapy. Ua hoʻemi nui ʻia nā hopena maikaʻi ʻole o kā lākou mau maʻi kūpilikiʻi:

• luhi;
• ʻeha;
• hoʻemi i ka neʻe.

Hoʻomaopopo pinepine nā mea maʻi i kēia hoʻomaʻamaʻa ma ke ʻano he hānau hou, ke manaʻo kekahi ua hala lākou i nā noho huila no ke ola.

Hoʻokumu pū mākou i kahi pōmaikaʻi o nā biotherapies e pili ana i ka makaʻu o nā maʻi maʻi maʻi maʻi: e hoʻoliʻiliʻi ʻia kēia pilikia e ka ʻoiaʻiʻo o ka hōʻemi ʻana i ka mea hoʻoweliweli o ka maʻi. E hoʻomaikaʻi ʻia ke ola o nā mea maʻi.

ʻO ka mea hope loa, ua paʻi ʻia kahi noiʻi i Lancet ma 2008 i lana ka manaʻo o ke kala piha ʻana o ka maʻi ma o ka hoʻohana ʻana i nā biotherapies. ʻO ka helu remission ma lalo o ka methotrexate he 28% a hiki i 50% inā hoʻohui ʻia ka receptor soluble me ka methotrexate. ʻO ke kumu o kēia kala ʻia ʻana ma lalo o ka lapaʻau e ukali ʻia e kahi hōʻemi hōʻemi o nā lāʻau, ma mua o ka loaʻa ʻana o ke kala holoʻokoʻa.

Eia nō naʻe, ʻaʻole he cytokine ka TNF-alpha e like me nā mea ʻē aʻe: ʻoiai he kuleana pro-inflammatory ia, kōkua pū ia i ka hakakā ʻana i nā maʻi a me ka maʻi ʻaʻai, ma ka luku ʻana i nā hunaola maʻi ʻaʻai. Ma ka hei ʻana i kēia mole, hoʻonāwaliwali hoʻi mākou i ke kino e kūʻē i ka makaʻu o nā tumors.

Ua aʻo ʻia kēia mau pilikia i nā noiʻi he nui me nā hoʻokolohua hoʻokolohua. Ke lawe nei i kēia mau noiʻi āpau i ka helu cancerous ua ana ʻia i pālua ʻia a pākolu ʻia paha me ka hoʻohana ʻana i nā antibodies monoclonal; a hoʻonui ʻia kahi makaʻu e 1,8 ma o ka hoʻohana ʻana i ka receptor anti-TNF soluble.

Eia nō naʻe, ma ka honua, ʻokoʻa ʻokoʻa ka ʻoiaʻiʻo: i nā papa inoa o nā mea maʻi ʻEulopa a me ʻAmelika i ukali ʻia a mālama ʻia e nā biotherapies, ʻaʻole kū kēlā piʻi i ka maʻi ʻaʻai. Ke makaʻala nei nā kauka ma kēia wahi, ʻoiai e ʻae nei i kahi makaʻu kūpono akā hoʻowahāwahā ʻia e ka pōmaikaʻi o ka biotherapy.

E pili ana i nā maʻi, ua manaʻo ʻia ka makaʻu o ka maʻi ʻino ma 2% o nā mea maʻi i kēlā me kēia makahiki ke hoʻomaka ka mumū (ma lalo o 6 mau mahina). Inā ʻelemakule ia, ʻo 5% ka makaʻu. Hōʻike kēia mau hopena i hiki i ka biotherapy ke hoʻopili i kēia mau pilikia ma waena o nā helu kūpono.

ʻO ke kāohi ʻana i kēia pilikia infectious e pili ana i nā hoʻolālā kānana ma mua o ke kuhikuhi ʻana i kahi anti-TNF i kahi mea maʻi. ʻO kahi hoʻokolohua hoʻokolohua piha, kahi nīnauele a me nā moʻo o nā hoʻokolokolo e pono ai (helu koko, transaminases, hepatitis serology (A, B, a me C), HIV ma hope o ka ʻae ʻana o ka mea maʻi, ka nānā ʻana a me ka hoʻohou ʻana o nā lāʻau āpau, ka mōʻaukala o ka maʻi kō.).

No laila pono e hoʻomake ʻia nā mea maʻi e kūʻē iā influenza a me ka pneumococcus ma mua o ka mālama ʻana, a e kipa aku i hoʻokahi mahina ma hope o ke kauka a laila ma kēlā me kēia ʻekolu mahina, i mea e loiloi ai i ka maikaʻi o ka mālama ʻana a me ka hopena o ka maʻi.