Descovy vs. Truvada: Umehluko, ukufana, nokuthi yikuphi okungcono kuwe
Izidakamizwa Vs. UmnganiUkubuka konke kwezidakamizwa nokwehluka okuyinhloko | Izimo zilashwa | Ukusebenza | Ukutholakala komshuwalense nokuqhathaniswa kwezindleko | Okuqhamuka uma udla imishanguzo | Ukusebenzisana kwezidakamizwa | Izexwayiso | Imibuzo evame ukubuzwa
Phakathi kwezinhlobo ezahlukahlukene zemithi ye-HIV laphaya, iDescovy (emtricitabine / tenofovir alafenamide) neTruvada (emtricitabine / tenofovir disoproxil fumarate) kukhona ama-antiretroviral agents ajwayele ukubekwa. Kwaphela iminyaka eminingi, iTruvada kwakuwukuphela kwesidakamizwa esivunyelwe i-FDA i-pre-exposure prophylaxis (PrEP) , noma ukuvimbela i-HIV. Kodwa-ke, ngo-Okthoba 2019, uDescovy naye wathola Ukuvunyelwa kwe-FDA kwe-PrEP .
Yomibili le mithi yenziwa yiGiliyadi Sciences, Inc. futhi isebenza ngezindlela ezifanayo ne-nucleoside reverse transcriptase inhibitors (NRTIs). Ukuze i-HIV iziphindaphinde, idinga ukudala i-DNA kusuka kumabhulokhi wokwakha abizwa ngama-nucleotide. UTruvada noDescovy bavimba i-enzyme ye-reverse transcriptase (RT), esebenzisa ama-nucleotide ukwenza guqula i-RNA ibe yi-DNA . Ngale ndlela, le mithi isiza ukuvimbela ukwakheka kwamagciwane amasha.
Yize yomibili imishanguzo iqukethe cishe izinto ezifanayo, inokuhluka okuthile emiphumeleni emibi, isilinganiso, nezinkomba.
Uyini umehluko omkhulu phakathi kukaDescovy noTruvada?
I-Descovy
IDescovy (Yini iDescovy?) Igama lomkhiqizo lenhlanganisela ye-emtricitabine (FTC) ne-tenofovir alafenamide (TAF). Ekuqaleni kwavunywa ngo-2015 ukwelapha abantu abadala nezingane abane-HIV-1 ukutheleleka.
I-TAF eDescovy inayo ukuzinza okuphezulu kwe-plasma kuqhathaniswa ne-TDF eTruvada. Ngenxa yalokhu, i-TAF inamandla kakhulu ngokugxila okuphezulu kumaseli atheleleke nge-HIV. Amaphilisi e-Descovy aqukethe ama-200 mg we-FTC kanye nama-25 mg we-TAF.
Truvada
I-Truvada (Yini iTruvada?) Igama lomkhiqizo we-emtricitabine (FTC) ne-tenofovir disoproxil fumarate (TDF). Ukuhlanganiswa kwale mithi kwavunywa yi-FDA ngo-2004 ekwelashweni nge-HIV.
Uma kuqhathaniswa noDescovy, iTruvada ikhonjiswe ukuthi inemiphumela emibi kakhulu ekusebenzeni kwezinso nasekucineni kwamathambo. Kubuye kube namandla aphezulu we-tenofovir prodrug TDF: 300 mg, 250 mg, 200 mg, no-100 mg.
Umehluko omkhulu phakathi kweDescovy neTruvada | ||
---|---|---|
I-Descovy | Truvada | |
Isigaba sezidakamizwa | Isidambisigciwane I-Nucleoside reverse transcriptase inhibitor (NRTI) | Isidambisigciwane I-Nucleoside reverse transcriptase inhibitor (NRTI) |
Isimo somkhiqizo / ejwayelekile | Ayikho inguqulo ejwayelekile etholakalayo | Uhlobo olujwayelekile luvunyiwe, kepha okwamanje alutholakali ngokuthengisa |
Ngubani igama elijwayelekile? | Emtricitabine / Tenofovir alafenamide | Emtricitabine / Tenofovir disoproxil fumarate |
Izidakamizwa zingena ngaziphi izinhlobo? | Ithebhulethi yomlomo | Ithebhulethi yomlomo |
Uyini umthamo ojwayelekile? | Ukwelashwa nge-HIV: 200 mg FTC / 25 mg TAF tablet kanye ngosuku noma ngaphandle kokudla I-PrEP: 200 mg FTC / 25 mg TAF tablet kanye ngosuku noma ngaphandle kokudla | Ukwelashwa nge-HIV: 200 mg FTC / 300 mg TDF tablet kanye ngosuku noma ngaphandle kokudla I-PrEP: Ithebhulethi engu-200 mg FTC / 300 mg TDF kanye ngosuku noma ngaphandle kokudla |
Yelashwa isikhathi esingakanani? | Alikho ikhambi lokutheleleka nge-HIV noma i-AIDS. Imishanguzo ye-antiretroviral kufanele iphuzwe ngokungaguquguquki nsuku zonke ukulawula igciwane. | |
Ubani ovame ukusebenzisa umuthi? | Ukwelashwa nge-HIV: Abantu abadala nezingane ezineminyaka engu-12 nangaphezulu abanesisindo okungenani sama-55 lbs I-PrEP: Abantu abadala nezingane ezineminyaka engu-12 nangaphezulu abanesisindo okungenani sama-75 lbs | Ukwelashwa nge-HIV: Abantu abadala nezingane ezineminyaka engu-12 nangaphezulu abanesisindo okungenani esingama-35 lbs I-PrEP: Abantu abadala nezingane ezineminyaka engu-12 nangaphezulu abanesisindo okungenani sama-75 lbs |
Izimo eziphathwe yi-Descovy ne-Truvada
IDescovy neTruvada zikhonjisiwe ukwelapha ukutheleleka nge-HIV zihlangene nezinye izidakamizwa. Uma isetshenziswa njengokwelashwa kwe-HIV, iDescovy noma iTruvada ivame ukusetshenziswa kanye ne-integrase inhibitor efana neTivicay (dolutegravir) noma i-protease inhibitor efana ne-Prezista (darunavir). IDescovy noma iTruvada nayo ingasetshenziswa nge-non-nucleoside reverse transcriptase inhibitor (NNRTI) efana neSustiva (efavirenz).
Kokubili iDescovy neTruvada kungasetshenziselwa ukuvimbela i-HIV, okunye okwaziwa ngokuthi yi-pre-exposure prophylaxis (PrEP). Kulabo abasengozini ye-HIV, iDescovy noma iTruvada bangaphuzwa kanye ngosuku ukuvimbela ukutheleleka nge-HIV. Labo abangaba sengozini yegciwane lesandulela ngculaza kubandakanya abantu abadala abazibandakanya ocansini kanye nentsha kanye nabasebenzisi bezidakamizwa i-IV (intravenous).
Ngoba i- idatha yokuvunywa kwe-PrEP ayizange ifake abesifazane be-cisgender, iDescovy ayivunyelwe ukusetshenziswa kulabo abasengozini evela ocansini lwesitho sangasese sowesifazane. UDescovy ufundelwe iPrEP kwabesifazane nabesilisa abenza ucansi nabesilisa. ITruvada ifundelwe i-PrEP kulezi zindawo ezifanayo nabasebenzisi bezidakamizwa ze-IV nemibhangqwana engabesilisa nabesifazane.
Isimo | I-Descovy | Truvada |
Ukutheleleka nge-HIV | Yebo | Yebo |
Ukuvimbela i-HIV (PrEP) | Yebo | Yebo |
Ngabe iDescovy noma iTruvada isebenza kangcono?
Kokubili iDescovy neTruvada kukhonjiswe ukuthi kuyasebenza ekwelapheni nasekuvimbeleni ukutheleleka nge-HIV. Kodwa-ke, njengomuthi omusha, iDescovy imakethwa yiGileyadi Sciences njengenketho ephephile nephumelela kakhulu. Impikiswano enkulu kaDescovy ilele ekugxileni okuphezulu komuthi kumaseli atheleleke nge-HIV anemiphumela emincane empilweni yezinso namathambo.
Izilingo eziningana zemitholampilo zikhombisile ukuthi i-TAF iyi okungekho ngaphansi ku-TDF yokwelapha ukutheleleka nge-HIV. Okusho ukuthi, i-TAF isebenza kahle njenge-TDF. I- Thola Isivivinyo kuyisivivinyo esisebenzayo esihlola ukuphepha nokusebenza kweDescovy kuqhathaniswa neTruvada ye-PrEP. Imiphumela evela ecaleni, ebandakanya ababambiqhaza abangu-5,387, ikhombise ukuthi iDescovy yayisebenza ngokufanayo eTruvada ngokuthuthuka okukhulu ekusebenzeni kwezinso nobuningi bamaminerali amathambo.
Kodwa-ke, odokotela abaningi nozakwabo bayangabaza ukuncoma uDescovy njengolayini wokuqala we-PrEP. Ngokusho kukaDkt. Krakower, udokotela oholayo kanye noprofesa osizayo eHarvard Medical School, ukuthuthuka kwephrofayili yezokuphepha kungenzeka kungabi njalo okubalulekile emtholampilo njengokusho kukaGileyadi. Ezinye izifundo zikhombisile ukuthi i-TAF eDeskovy nayo ingafaka isandla ukuzuza kwesisindo kwezinye iziguli.
Ngaphandle kokusebenza ngempumelelo nokuphepha kwabo, bobabili uDescovy noTruvada basebenza kuphela lapho bethathwa ngokungaguquguquki nsuku zonke. Ngaphandle kokunamathela ngokufanele emithini, ubungozi bokumelana ne-HIV buyanda. Kubalulekile ukuxoxa ngemithi etholakalayo ye-HIV nomhlinzeki wezokunakekelwa kwezempilo ukuze kunqunywe indlela engcono yokwelashwa.
Ukuqhathaniswa kanye nezindleko zokuqhathaniswa kweDescovy vs. Truvada
UDescovy noTruvada beza ngenani eliphakeme. Izindleko zokuthengisa ezijwayelekile zomuthi othile zingaphezu kwama- $ 2,000. Ngenhlanhla, le mithi ivame ukumbozwa yi-Medicare nezinhlelo zomshuwalense. Kulabo abangenawo umshuwalense, izinhlelo zosizo ziyatholakala ukusiza ukukhokha izindleko. IGileyadi, umkhiqizi wale mithi, inikezela ngeyayo
Thola ikhadi lesaphulelo se-SingleCare
I-Descovy | Truvada | |
Ngokuvamile embozwe umshwalense? | Yebo | Yebo |
Imbozwe ngokujwayelekile yi-Medicare? | Yebo | Yebo |
Umthamo ojwayelekile | Ithebhulethi eyodwa (200 mg FTC / 25 mg TAF) nsuku zonke | Ithebhulethi eyodwa (200 mg FTC / 300 mg TDF) nsuku zonke |
I-Medicare copay ejwayelekile | $ 42- $ 1,807 | $ 42– $ 1,827 |
Izindleko ze-SingleCare | $ 1,821 + | $ 1,871 + |
Imiphumela emibi ejwayelekile yeDescovy vs. Truvada
Okuvame kakhulu imiphumela emibi ye-Descovy kufaka phakathi isicanucanu, uhudo, nokukhathala. Eminye imiphumela emibi ifaka phakathi ubuhlungu besisu noma ubuhlungu besisu kanye nokuphathwa yikhanda. Truvada kungadala nemiphumela emibi efanayo.
Ngokwe-Discover Trial, labo abathatha iTruvada baba nohudo oluningi, isicanucanu, ukukhathala, nobuhlungu besisu uma kuqhathaniswa nalabo abathatha iDescovy. Lokhu kwehluka kwemiphumela emibi, noma kunjalo, kungahle kungabi kukhulu ngokwanele ukuba nomthelela omuhle ekwelashweni.
Imiphumela emibi kakhulu ye-Descovy ne-Truvada ingafaka ukuqubuka noma ezinye izimpawu zokuphendula okweqile. Le mithi futhi inamandla okubangela ukungasebenzi kahle kwezinso nokuncipha kwamaminerali amathambo.
I-Descovy | Truvada | |||
Umphumela oseceleni | Kusebenza? | Imvamisa | Kusebenza? | Imvamisa |
Uhudo | Yebo | 5% | Yebo | 6% |
Isicanucanu | Yebo | 4% | Yebo | 5% |
Ukukhathala | Yebo | amaphesenti amabili | Yebo | 3% |
Ubuhlungu besisu | Yebo | amaphesenti amabili | Yebo | 3% |
Ubuhlungu bekhanda | Yebo | amaphesenti amabili | Yebo | amaphesenti amabili |
Lokhu kungenzeka kungabi uhlu oluphelele lwemiphumela emibi engenzeka. Sicela ubheke udokotela wakho noma umhlinzeki wezokunakekelwa kwempilo ukuze ufunde kabanzi.
Umthombo: DailyMed ( I-Descovy ), IDailyMed ( Truvada )
Ukusebenzisana kwezidakamizwa kweDescovy vs. Truvada
IDescovy ingasebenzisana nama-protease inhibitors (ama-PIs), ama-anticonvulsants, ama-antimycobacterial agents kanye nemikhiqizo yamakhambi. I-PI yesidambisigciwane efana ne-tipranavir inganciphisa izinga nokusebenza kwe-Descovy. Ama-Anticonvulsants, ama-antimycobacterials, kanye nemithi ethile yamakhambi efana ISt. John's Wort kunganciphisa nokusebenza kwe-Descovy.
I-Truvada ingaxhumana nama-protease inhibitors afana ne-lopinavir, i-atazanavir, ne-darunavir. Ukuthatha le mithi ngeTruvada kungakhuphula amazinga e-tenofovir, okudala imiphumela emibi. ITruvada nayo ingaxhumana ne-didanosine futhi inyuse ukugxila kwayo. Ukukhuphuka kwamazinga e-didanosine kungaholela emiphumeleni emibi efana ne-pancreatitis ne-neuropathy.
Kokubili uDescovy noTruvada bangasebenzisana nemithi elwa namagciwane esetshenziselwa ukwelapha iHepatitis C. Izidakamizwa ezinjengeHarvoni (ledipasvir / sofosbuvir) zingathinta amazinga e-Descovy noma eTruvada. Izinga lezidakamizwa eliguqukile lingaholela ekwehleni kokusebenza noma kwemiphumela emibi eyengeziwe.
Izidakamizwa | Isigaba Sezidakamizwa | I-Descovy | Truvada |
Atazanavir I-Ritonavir I-Darunavir I-Tipranavir | Ama-Protease inhibitors (ama-PIs) | Yebo | Yebo |
I-Sofosbuvir / velpatasvir I-Sofosbuvir / velpatasvir / voxilaprevir Ledipasvir / sofosbuvir | Izidambisigciwane ze-Hepatitis C | Yebo | Yebo |
ICarbamazepine I-Oxcarbazepine Phenytoin | Ama-anticonvulsants | Yebo | Akunjalo |
I-Rifampin I-Rifabutin | Ama-Antimycobacterial agents | Yebo | Akunjalo |
ISt. John's Wort | Amakhambi | Yebo | Akunjalo |
I-Didanosine | I-Nucleoside reverse transcriptase inhibitor (NRTI) | Akunjalo | Yebo |
* Thintana nochwepheshe wezokunakekelwa kwempilo ngokunye ukuxhumana nezidakamizwa
Izexwayiso zedescovy netruvada
Abantu abayeka i-Descovy noma i-Truvada bangazwela kakhulu ukutheleleka kwegciwane le-hepatitis B (HBV) . Umsebenzi wesibindi kufanele ubhekwe kubantu abanesifo se-HBV ngemuva kokuyeka iDescovy noma iTruvada. Ukwelashwa kwe-Hepatitis B nakho kungaqinisekiswa kulezi zimo.
Ngoba i-tenofovir ngokuyinhloko isuswa ngezinso, iDescovy neTruvada zingaqinisa ukusebenza kwezinso. IDescovy neTruvada nazo zingathinta ukuminyana kwamathambo (BMD). Labo abanomlando wesifo sezinso noma i-osteoporosis kufanele babhekwe lapho besebenzisa iDescovy noma iTruvada.
IDescovy neTruvada kufanele zisetshenziselwe i-PrEP kuphela kubantu abaqinisekisiwe ukuthi abanayo i-HIV. Kubalulekile ukuhlolela i-HIV ngezikhathi ezithile ngenkathi uthatha iDescovy noma iTruvada. Ngaphandle kwalokho, kunengozi yokuthola i-HIV engazweli emithini, okungaba nzima ukuyelapha.
Khuluma nomhlinzeki wezokunakekelwa kwempilo ukuze ufunde ngezingozi zeminye imiphumela emibi engaba khona. Umlando wakho wezokwelapha neminye imithi oyiphuzayo nayo ingathinta indlela ophendula ngayo ku-Descovy noma eTruvada.
Imibuzo ebuzwa njalo nge-Descovy vs. Truvada
Kuyini iDescovy?
IDescovy yiphilisi elenziwa kanye ngosuku elenzelwa ukwelapha ukutheleleka nge-HIV. Iphinde isetshenziselwe i-HIV pre-exposure prophylaxis (PrEP) kulabo abasengozini. IDescovy iqukethe inhlanganisela ye-emtricitabine (FTC) ne-tenofovir alafenamide (TAF).
Yini iTruvada?
I-Truvada ngumuthi wezidambisigciwane osetshenziselwa ukwelapha ukutheleleka nge-HIV. Kujwayele ukubekwa njengethebhulethi yansuku zonke ye-HIV PrEP kulabo abasengozini ye-HIV. ITruvada iqukethe inhlanganisela ye-emtricitabine (FTC) ne-tenofovir disoproxil fumarate (TDF)
(Yini iTDF?).
Ngabe uDescovy noTruvada bayafana?
IDescovy neTruvada zombili zenziwa yiGileyadi Sciences. Kodwa-ke, azisona isidakamizwa esifanayo. IDescovy ngumuthi omusha oqukethe i-tenofovir alafenamide (TAF). ITruvada iqukethe i-tenofovir disoproxil fumarate (TDF).
Ngabe iDescovy noma iTruvada ingcono?
IDescovy neTruvada yizidakamizwa eziphumelelayo zombili zokwelashwa kwe-HIV ne-PrEP. IDescovy ayonakalisi ukusebenza kwezinso noma yehlise ukuqina kwamathambo njengeTruvada. Kodwa-ke, iTruvada isidakamizwa esidala esinedatha eyengeziwe yokuxhasa ukusetshenziswa kwayo kwezinye izimo. Kubalulekile ukuxoxa ngalezi zinketho nodokotela ukuze unqume ukwelashwa okungcono kakhulu kuwe.
Ngingasebenzisa iDescovy noma iTruvada ngenkathi ngikhulelwe?
Abukho ubufakazi obuphakamisa ukuthi iDescovy noma iTruvada iyingozi enganeni engakazalwa. Imithi ye-PrEP ingaphepha futhi ibekezelelwe ngesikhathi sokukhulelwa. Kodwa-ke, le mithi kufanele isetshenziswe kuphela uma izinzuzo zidlula izingozi. Xhumana nodokotela wakho uma ukhulelwe futhi njengamanje uthatha noma ucabanga umuthi wokulwa negciwane lengculazi.
Ngingasebenzisa iDescovy noma iTruvada ngotshwala?
Akunconyelwa ukuthi uphuze utshwala ngenkathi uthatha iDescovy noma iTruvada. Ukwenza kanjalo kungakhuphula imiphumela emibi yale mithi efana nesicanucanu nekhanda. Ukuphuza ngokweqile nokuncika nakho kuhlotshaniswa nokuziphatha okuyingozi okukhulayo okungaholela engcupheni ephezulu ye-HIV.
Ngabe kufanele ngisuke eTruvada ngiye eDescovy?
IDescovy ikhonjiswe njengeyindlela ephephile nephumelelayo ye-PrEP eya eTruvada kubantu abathile. Kodwa-ke, ukushintshwa okusuka eTruvada kuye eDescovy kungokubona kukadokotela wakho kanye nokwahlulela kwabo komtholampilo.
Ngabe i-Descovy ivunyelwe i-PrEP?
IDescovy yamukelwa i-PrEP engxenyeni yokugcina ka-2019. Kuyi-FDA evunyelwe ukuvikela i-HIV kulabo abasengozini ye-HIV, ngaphandle kwalabo abasengozini yokuya ocansini lobulili besifazane. UDescovy wafundelwa iPrEP kwabesilisa abathandana nabesilisa abesilisa nabesifazane kanye nabesifazane abangama-transgender.
Ngabe iTruvada imbi ngezinso?
Sebenzisa iTruvada kungaholela ku- ukusebenza kahle kwezinso , ikakhulukazi kulabo abasengozini yokulimala kwezinso. I-Truvada kufanele igwenywe ngenkathi ithatha izidakamizwa ze-nephrotoxic njengama-NSAID angalimaza izinso. Udokotela wakho angahlola ukusebenza kwezinso zakho ngaphambi kokuqala iTruvada.