Lolemba 21 September 2015 ndi Tsiku la Alzheimer Padziko Lonse ndipo limasonyezanso kumapeto kwa Mwezi wa World Alzheimer. Matenda a Alzheimer's ndi matenda omwe akupita patsogolo momvetsa chisoni omwe amasautsa okalamba, omwe amakhudza kukumbukira kukumbukira, kusokonezeka maganizo komanso mavuto aakulu a thanzi. Palibe chithandizo ndipo kafukufuku wasonyeza kuti mankhwala omwe amagwiritsidwa ntchito panopa samabweretsa zotsatira ndipo akhoza kuvulaza. Komabe mankhwalawa akupitilizabe kugwiritsidwa ntchito tsiku lililonse ku North America ndi ku Europe.
Pamsonkhano wolemekeza tsikuli ku France, Pulofesa Olivier Saint-Jean, wamkulu wa geriatrics pa Georges Pompidou European Hospital ku Paris, adabwereza chenjezo lake kuti mankhwala osagwira ntchito komanso nthawi zina oopsa akupitilizabe kuperekedwa kwa odwala Alzheimer. Ananenanso motsindika kuti palibe mankhwala omwe apangidwa a Alzheimers omwe atsimikizira kuti ndi othandiza komanso amalimbikitsa njira zina zothandizira panthawiyi.
Mankhwala onse asanu ovomerezedwa ndi FDA omwe cholinga chake ndi kuchepetsa kufalikira kwa dementia komanso mankhwala ena omwe amaperekedwa kuti athetse kupsinjika kwa anthu omwe ali ndi matenda a Alzheimers atsimikiziridwa mobwerezabwereza kwa zaka zopitirira khumi m'maphunziro apadziko lonse kuti sakhala osagwira ntchito, komanso kubweretsa zotsatira zoyipa. Ndipo komabe mankhwalawa akadali mwachizolowezi, ngakhale kwenikweni, amatchulidwa koyambirira komanso nthawi yonse ya matendawa. Kuonjezera apo, magulu atsopano a mankhwala awonetsedwanso kuti sakugwira ntchito m'zaka zingapo zapitazi.
Polankhula pamsonkhano wina chaka chatha, Pulofesa Saint-Jean ananena izi:
"Mankhwalawa adatuluka m'zaka za m'ma 1990 ndipo akugwiritsidwabe ntchito mpaka pano ngati gawo la zida zochizira dziko lonse ndipo, poyang'ana kumbuyo, ndi othandiza kwambiri. A French Health Authority adawawunikanso zaka ziwiri zapitazo, ndipo padziko lonse lapansi zidapezeka kuti mankhwalawa ali ndi zofooka zomwe siziyenera kuganiziridwa, kunena mosabisa, kuti mwina ali pafupi kuchita chilichonse. Koma iwo sali osalakwa kwambiri, makamaka poganizira kuti amagwiritsidwa ntchito kwa anthu okalamba kwambiri omwe ali ndi matenda ena ndikumwa mankhwala ena, zomwe zimayambitsa kuyanjana kwina. Chifukwa chake iyi inali njira yomwe masiku ano yatsimikiziridwa kukhala yosagwira ntchito ndipo iyenera kusiyidwa pakapanda kusowa kwazinthu zatsopano zamakampani opanga mankhwala okhudza mitundu iyi ya mamolekyu. Mwina njira iyi idzabadwanso tsiku lina, koma pakadali pano sikugwira ntchito. โ [1]
Malinga ndi Prof. Saint-Jean, kubwerezabwereza maphunziro pambuyo pophunzira za mankhwala onsewa kumatsutsa kukayikira kwina kwa akuluakulu azaumoyo, mafakitale ndi madokotala. Poyankhulana ndi Eric Favereau yofalitsidwa mu Libรฉration yamasiku ano, atafunsidwa chifukwa chake madokotala akupitirizabe kupereka mankhwalawa, Prof. Saint-Jean anayankha mosakayikira:
"Ngati tisiya mikangano yayikulu, palinso malingaliro azachipatala a momwe angaperekere matenda a Alzheimer popanda kutsatira, 'koma ndikukupatsani chithandizo'. Tsopano tili ndi chisamaliro chapadziko lonse lapansi chomwe titha kupereka, ndi malo osamalira usiku, malo okumbukira, magulu azachipatala. Palibe chimene chingalungamitse kupitirizabe kupereka mankhwala opanda pake.โ[2]
Kuchokera kumalingaliro abizinesi, komabe, kulimbikitsa ndi kufufuza mankhwala a Alzheimer's kumapanga malingaliro opotoka. "Anthu ena amawona ngati tikiti ya lottery yagolide," adalemba John Carroll, wa FiercePharma, mu imelo ku CBS News mu Januware. "Zovuta zotsutsana ndikuchita bwino ndizodabwitsa, koma ngati mutapeza zambiri zopambana za FDA zomwe zingafune kuvomereza china chake komanso mamiliyoni a odwala omwe ali ndi vuto popanda zosankha zenizeni, zingakhale zopindulitsa, ngakhale sizili bwino. โ
CBS idafunsanso mlangizi wamakampani opanga mankhwala a Daniel Hoffman, "Tangoganizani zomwe anthu angalipire kapena kulipira kuti athetse matenda a Alzheimer's. Mutha kupeza munthu aliyense kumayiko otukuka kuti azitenga usiku uliwonse. โ Malinga ndi lipotilo, Hoffman amawona msika woterewu uli mu mabiliyoni a madola. [3]
Pali mankhwala asanu omwe avomerezedwa ndikuperekedwa kwa odwala Alzheimer's, ndipo madokotala nthawi zambiri amaperekanso mankhwala oletsa psychotic omwe alibe chizindikiro kuti achepetse kukhumudwa. Mankhwala anayi mwa asanu oyambirira ndi acetylcholineresterase inhibitors (omwe ndi donepezil, galantamine, tacrine ndi rivastigmine), winayo ndi glutamate receptor antagonist memantine. Kuphunzira pophunzira kwawonetsa kuti sizothandiza kuposa placebo. Mankhwala ena anayi aposachedwa, gantenerumab, flurizan, bapineuzemab ndi semagacestate, onse awona ntchito zawo zofufuza ndi chitukuko zitayimitsidwa ndikubwezeredwa chifukwa chosowa umboni woti anali kupereka phindu lililonse kwa omwe akudwala matendawa.
Antipsychotics monga olanzapine (Zyprexa), quetiapine (Seroquel) ndi risperidone (Risperdal), omwe amagwiritsidwa ntchito poyambitsa mikhalidwe monga schizophrenia, nthawi zambiri amalembedwa kuti athetse kusokonezeka ndi chiwawa mu Alzheimers, koma zapezeka kuti sizothandiza kuposa placebo, ndi kuvulaza kowonjezereka kwa kuchititsa kusowa tulo, Parkinson's, ndi kusokonezeka maganizo kowonjezereka.
Zonsezi zakhala zikudziwika kwa zaka zambiri. Chidziwitsochi ndi chofala pakati pa odziwitsidwa kotero kuti Consumer Reports, mu kope lawo la Meyi 2012 la "Best Buy Drugs: Evaluating Prescription Drugs to Treat: Alzheimer's Disease," akutero:
Mankhwala omwe amagwiritsidwa ntchito pochiza matenda a Alzheimer's sathandiza kwenikweni. Poyerekeza ndi placebo, anthu ambiri omwe amamwa sadzakhala ndi phindu lililonse. Ndipo ndi munthu wosowa yemwe amachedwa kuwonjezereka kwa zizindikiro zawo pakapita nthawiโฆ.
Chifukwa anthu ambiri omwe amamwa mankhwala a Alzheimer's sadzalandira phindu lililonse, kuphatikiza mtengo wamtengo wapatali komanso chiwopsezo chazovuta zachitetezo chosowa koma chofunikira, sitingathe kusankha mankhwala aliwonsewa ngati Best Buy." (mlembi wotsindika) [4]
Mu 2011, memantine (dzina la dzina la Namenda) adawonetsedwa kuti sagwira ntchito pa kafukufuku wa pa yunivesite ya Southern California. โTimaona kuti pali kusowa kwa mphamvu mu Alzheimerโs wochepa,โ anatero wofufuza wamkulu, Lon Schneider, MD, pulofesa wa zamaganizo, minyewa, ndi gerontology. "Tikuganiza kuti madokotala, odwala, ndi osamalira ayenera kudziwa izi."[5]
Pa 30 Nov 2007, ofufuza a ku Italy ku National Institute of Health ku Rome analemba kuti:
"Acetylcholinesterase inhibitor mankhwala sangathe kuchedwetsa kupita patsogolo kuchokera ku mild cognitive impairment (MCI) kupita ku dementia. Kuwunikanso zomwe zilipo, zosindikizidwa komanso zosasindikizidwa, kuchokera ku mayesero asanu ndi limodzi osiyanasiyana, Roberto Raschetti ndi ogwira nawo ntchito ku National Institute of Health, Rome, Italy, kuphatikizapo Emiliano Albanese, Nicola Vanacore, ndi Marina Maggini, atsimikiza kuti odwala MCI omwe amamwa mankhwalawa amatha kudwala matenda a dementia. pamlingo wofanana ndi omwe amatenga placebo. Zotsatira zitha kuyambitsanso mkangano ngati MCI iyenera kuthandizidwa, ndipo ngati ndi choncho, bwanji. โ[6]
Kafukufuku wakumayambiriro kwa chaka cha 2005 akuwonetsa kuti galantamine (dzina la Reminyl) "sinachedwetse kuoneka kwa dementia ndikuwonjezera chiopsezo cha mtima, malinga ndi zotsatira za kafukufuku yemwe adachitika kwa zaka ziwiri. Odwala opitilira 2,000โฆanatsatiridwa ku Europe, Australia, Argentina ndi United Statesโฆ. Zotsatira zinawonetsa kuti mankhwalawa sanali othandiza kuposa placebo pochedwetsa kuyambika kwa dementia. Kuphatikiza apo, chiwerengero cha anthu omwe amafa m'gulu lomwe amathandizidwa ndi galantamine (15) chinali chochulukirapo kuposa omwe amafa pa placebo (5)."[7]
Mu 2004, donepezil (Aricept) inasonyezedwa kuti ili ndi zotsatira zotsitsimula pang'ono, ngakhale kafukufuku wakale ku UK chaka chimenecho sanawonetse kusintha.[8]
Malinga ndi Harvard Medical School ya Harvard Mental Health Newsletter:
Tinkayembekezedwa kuti mankhwala amene nthawi zambiri amaperekedwa kwa odwala matenda a Alzheimer angathandize anthu amene ali ndi vuto la delirium, koma kafukufuku wina anapeza kuti amapangitsa kuti vutolo liipire kwambiri.[9]
Ndipo potsiriza, kafukufuku wa 2006 wa New England Journal of Medicine wokhudzana ndi kugwiritsidwa ntchito kwa anti-psychotics m'gulu la Alzheimer's adatsimikiza kuti:
"Zotsatira zoyipa zimathetsa ubwino wogwiritsa ntchito mankhwala osokoneza bongo a atypical antipsychotic pochiza psychosis, nkhanza, kapena kusokonezeka kwa odwala omwe ali ndi matenda a Alzheimer's."[10]
Nkhani ya New York Times pa kafukufuku wa NEJM inali ndi izi:
โLipotilo, lozikidwa pa kuyerekeza kwakukulu kwa boma kwa mphamvu ya mankhwalawo, likutsutsa kwambiri machitidwe amakono kotero kuti likhoza kusintha mwamsanga zizoloลตezi za kupereka mankhwala, akatswiri ena anatero (wolemba kutsindika). Pafupifupi anthu 4.5 miliyoni a ku America amadwala matenda a Alzheimer's, ndipo odwala ambiri omwe ali ndi matendawa nthawi zina amakhala akuvutika maganizo kapena kuganiza molakwika.
Zachisoni pafupifupi zaka khumi pambuyo pake, zikuwoneka kuti palibe chomwe chasintha. Koma pali gulu ku Europe lomwe likukula pang'onopang'ono. Pochoka ku chithandizo chamankhwala, A Dutch adapanga Hogeway m'tauni ya Weesp, yotchedwa mudzi wa dementia, yopereka chisamaliro pamtengo wofanana ndi nyumba zosungira anthu okalamba koma m'malo opereka ufulu wochulukirapo.[12] Boma la France lero lalengeza za ndalama zothandizira mudzi wa Alzheimer m'chigawo cha Landes, ndikuupatsa mphotho ya pachaka ya ma euro 3 miliyoni kuti agwire ntchito. Kukwaniritsidwa kwake kudzachitika mu 2018.[13]
Danica Jorden ndi wolemba komanso womasulira wa Chifalansa, Chisipanishi, Chipwitikizi ndi Chitaliyana.
[1] https://www.youtube.com/watch?v=lqhPnRAYy5g (zolemba ndi kumasulira ndi wolemba)
[2] http://www.liberation.fr/politiques/2015/09/20/alzheimer-le-pr-olivier-saint-jean-veut-en-finir-avec-les-medicaments-inefficaces_1386908 (kumasulira kwa wolemba )
[3] http://www.cbsnews.com/news/will-a-cure-for-alzheimers-ever-be-found/
[4] "Kuwunika Mankhwala Omwe Amagwiritsidwa Ntchito Pochiza: Matenda a Alzheimer's โข Consumer Reports Best Buy Drugs." Lipoti lasinthidwa Meyi 2012 https://www.consumerreports.org/โฆdrugs/AlzheimersFโฆ
[5] http://www.cnn.com/2011/HEALTH/04/11/alzheimer.drug.ineffective/
[6] http://www.alzforum.org/news/research-news/researchers-conclude-cholinesterase-inhibitors-dont-delay-alzheimers
[7][8] http://www.afpap.org/Alzheimer_medicament_27012004.htm (kumasulira kwa wolemba)
[9] http://www.health.harvard.edu/newsletter_article/alzheimers-drug-proves-ineffective-for-delirium
[10] Nambala ya ClinicalTrials.gov, NCT00015548. http://www.nejm.org/doi/full/10.1056/NEJMoa061240
[11] http://www.nytimes.com/2006/10/12/health/12dementia.html
[12] http://www.theguardian.com/society/2012/aug/27/dementia-village-residents-have-fun
[13] http://www.english.rfi.fr/france/20150921-alzheimers-village-france-given-green-light
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