Cutar tarin fuka mai jure wa miyagun ƙwayoyi (MDR TB) tana shafar mutane rabin miliyan kowace shekara. Ana ba da shawarar Levofloxacin don rigakafin rigakafi bisa ga bayanan lura, duk da haka babu wata shaida daga babban gwajin asibiti. TB CHAMP da V-QUIN, gwaje-gwaje na asibiti na kashi biyu na 3 sun kimanta aminci da ingancin levofloxacin don hana MDR tarin fuka a cikin mahalarta tare da fallasa gida zuwa kamuwa da cutar ta M. tarin fuka. An gano Levofloxacin don rage yawan kamuwa da tarin fuka-juriya da yawa a cikin duka binciken amma raguwar abin da ya faru ba shi da mahimmanci. Wani bincike-bincike na bayanai daga gwajin TB CHAMP da gwajin V-QUIN ya nuna cewa levofloxacin yana da alaƙa da raguwar 60% na kamuwa da tarin fuka a cikin abokan hulɗar MDR-TB na gida.
Mycobacterium tarin fuka mai jure wa isoniazid da rifampin yana shafar kusan mutane rabin miliyan kowace shekara a duniya. Ita ce ke da alhakin cutar tarin fuka mai jure wa magunguna da yawa (MDR) wanda ke ƙalubalantar shirye-shiryen sarrafa tarin fuka. Musamman, yara ƙanana waɗanda ke fama da kamuwa da cutar tarin fuka (MDR) a gida suna da haɗarin kamuwa da cuta. Kimanin yara miliyan 2 'yan kasa da shekaru 15 suna kamuwa da cutar ta MDR M. tarin fuka.
Levofloxacin, maganin rigakafi na ƙarni na uku na fluoroquinolone da ake sha da baki, wanda shine ɓangare na daidaitaccen jiyya don juriya na rifampicin ko tarin fuka na MDR an ba da shawarar bisa ga bayanan lura don rigakafin rigakafin kamuwa da tarin tarin fuka da yawa (MDR), duk da haka shaida daga manyan gwaji. a kan ingancinsa ba ya samuwa.
Gwaje-gwaje na asibiti manya guda biyu - TB CHAMP da V-QUIN sun bincika aminci da ingancin levofloxacin a cikin rigakafin rigakafin MDR TB bayan kamuwa da cuta mai jurewa da yawa. An buga sakamakon binciken da ƙarshen binciken biyu akan 3 Disamba 18.
The CHAMP na TB (Gwargwadon Maganin Rigakafin Rigakafin Rigakafin Cutar Cutar Cutar Cutar Cutar Cutar Cutar Ciki) ta kimanta inganci da amincin rigakafin rigakafin tare da levofloxacin a cikin yara da samari tare da fallasa gida ga tarin fuka mai jurewa da yawa. An gudanar da shi a kan yara 922 da matasa tare da kamuwa da cutar tarin fuka da yawa a cikin watanni 6 da suka gabata (amma ba tare da shaidar tarin fuka ba) daga gidaje 497 a wurare da yawa a Afirka ta Kudu. Mahalarta sun karɓi levofloxacin ko placebo kowace rana don makonni 24. Mahalarta 453 sun sami levofloxacin kuma sauran 469 an ba su placebo. A mako na 48, tarin fuka ya haɓaka a cikin mahalarta 5 (1.1%) a cikin rukunin levofloxacin kuma a cikin mahalarta 12 (2.6%) a cikin rukunin placebo. Don haka, maganin rigakafi da levofloxacin ya rage yawan kamuwa da cutar tarin fuka a tsakanin yara da matasa masu kamuwa da cutar ta MDR TB amma raguwar abin da ya faru bai yi ƙasa da placebo ba.
Sauran binciken (wanda ake kira Gwajin V-QUINAn tantance inganci da amincin tsarin watanni 6 na levofloxacin don rigakafin cutar tarin fuka a tsakanin abokan hulɗar gida na mutanen da aka tabbatar da rigakafin rifampicin ko tarin fuka da yawa (MDR). An gudanar da wannan gwaji a wurare da yawa a Vietnam a kan mahalarta 2041 waɗanda suka kasance abokan gida na mutanen da ke da rifampicin resistant ko MDR tarin fuka. Mahalarta sun kamu da cutar ta tarin fuka amma babu wata cuta mai aiki kuma sun fara magani a cikin watanni 3 da suka gabata. An ba wa mahalarta damar ba da izini don karɓar watanni 6 na levofloxacin na yau da kullun ko placebo. Mahalarta 1023 sun sami levofloxacin yayin da Mahalarta 1018 placebo. A cikin watanni 30, mahalarta 6 (0.6%) a cikin rukunin levofloxacin an tabbatar da su ta hanyar ƙwayoyin cuta sun kamu da tarin fuka yayin da mahalarta 11 (1.1%) a cikin rukunin placebo an tabbatar da su ta hanyar ƙwayoyin cuta. Bugu da ari, mahalarta 1 a cikin rukunin levofloxacin da 2 a cikin rukunin placebo an gano su a asibiti tare da tarin fuka. Don haka, abin da ya faru na cuta ya kasance ƙasa ga ƙungiyar levofloxacin fiye da placebo, amma bambancin ba shi da mahimmanci.
Dukkanin manyan gwaje-gwajen lokaci na 3 da aka ambata a sama sun bincika inganci da amincin levofloxacin don hana cututtuka tsakanin mahalarta tare da bayyanar da gida ga tarin fuka mai jure wa magunguna da yawa. A cikin TB CHAMP, mahalarta ba su da wata shaida game da tarin fuka, yayin da a cikin gwajin V-QUIN, mahalarta sun kamu da cutar M. tarin fuka amma babu wata cuta mai aiki. A cikin al'amuran biyu, an gano levofloxacin don rage yawan cututtuka, amma raguwa ba shi da mahimmanci.
Duk da haka, nazarin bayanan da aka yi daga gwajin TB CHAMP da V-QUIN ya nuna cewa levofloxacin yana da alaƙa da raguwar 60% na kamuwa da tarin fuka a cikin abokan hulɗar MDR-TB na gida.
A watan Satumba na 2024, da WHO ya ba da shawarar levofloxacin don rigakafin rigakafin MDR-TB bisa nazarin wannan shaidar gwaji.
A halin yanzu ana kimanta Delamanid a cikin gwaji na asibiti don rigakafin rigakafin MDR TB. Wani wakili ne na rigakafin ƙwayoyin cuta wanda ke hana haɗin bangon ƙwayoyin ƙwayoyin cuta na mycobacterial kuma an yarda da shi don maganin tarin fuka mai jure magunguna da yawa.
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References:
- Hesseling AC et al 2024. Maganin rigakafi na Levofloxacin a cikin yara da aka fallasa zuwa tarin fuka na MDR. An buga 18 Disamba 2024. N Engl J Med 2024;391:2315-2326. Vol. 391 No. 24. https://www.nejm.org/doi/full/10.1056/NEJMoa2314318
- Fox GJ, et al. An buga 2024 Disamba 18. N Engl J Med 2024; 2024: 391-2304. Vol. 2314 No. 391. DOI: https://www.nejm.org/doi/full/10.1056/NEJMoa2314325
- Duong T., et al 2024. A Meta-Analysis of Levofloxacin don Lambobin Cutar Tarin Fuka-Mai-Tsarki. An buga 18 Disamba 2024. Shaidar NEJM. DOI: https://evidence.nejm.org/doi/full/10.1056/EVIDoa2400190
- Dorman SE 2024. Magungunan rigakafi na Levofloxacin ga mutanen da suka kamu da tarin fuka na MDR. An buga 18 Disamba 2024. N Engl J Med 2024; 391: 2376-2378. Vol. 391 No. 24. https://www.nejm.org/doi/full/10.1056/NEJMe2413531
- MRC-UCL. Gwajin TB-CHAMP ya samo magani mai aminci da inganci na farko don hana tarin tarin fuka a yara. 19 Disamba 2024. Akwai a https://www.mrcctu.ucl.ac.uk/news/news-stories/2024/december/tb-champ-trial-finds-first-ever-safe-and-effective-treatment-to-prevent-multidrug-resistant-tb-in-children/
- HUKUMAR LAFIYA TA DUNIYA. Takaitacciyar gwajin TB CHAMP da V-QUIN na asibiti. https://tbksp.who.int/en/node/2745
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