Skip to main content
Login | Suomeksi | På svenska | In English

Browsing by Subject "hepatitis C"

Sort by: Order: Results:

  • Pseudoceratina purpureasta löydettyjen bromityrosiinien synteesi 
    Flemmich, Paul (2015)
    There are dozens of bromotyrosine alkaloids extracted from the marine sponge Pseudoceratina purpurea. Bromotyrosines have for example antibacterial, antiviral and antitumor activity in vitro and therefore bromotyrosines are potential drug lead molecules. By far, bromotyrosines have been extracted from different marine sponges of the Verongida order for the use in biological activity research. Collecting marine sponges by scuba diving is neither fast nor ecological and therefore finding an effective synthesis strategy is vital so that the research could continue. One new bromotyrosine, purpurealidin I, was found from the marine sponge Pseudoceratina purpurea in the four year (2010-2014) Marex-project. The aim of this thesis was to synthesize the compound purpurealidin I and its derivatives. Synthesized compounds were tested against hepatitis C and chikungunya viruses. It is important to find new potent drug molecules, because approximately 350 000-500 000 people die from hepatitis C and there is no curative medication for the chikungunya. Purpurealidin I is synthesized from tyrosine and tyramine parts, which will be put together to form an amide bond in the final step of the synthesis. The synthesis of purpurealidin I was not completed during the Master's thesis. However there were two purpurealidin I derivatives and four purpurealidin I tyramine part derivatives that were successfully synthesized. One of the compounds is purpurealidin E, which can be extracted from the sponge Pseudoceratina purpurea. The t-Boc derivative of purpurealidin E was examined against hepatitis C and chikungunya and the compound showed moderate activity against hepatitis C virus, but it wasn't active against chikungunya virus. The original plan to synthesize purpurealidin I is possible, although some reactions and purification of crude products need to be optimized in order to get better yields. For the future research derivatives of the t-Boc derivative of purpurealidin E should be synthesized and studied against hepatitis C virus.
  • Toisen polven virusspesifisten lääkkeiden kustannusvaikuttavuus C-hepatiitin hoidossa verrattuna standardihoitoon : järjestelmällinen kirjallisuuskatsaus 
    Konttinen, Riikka (2017)
    Hepatitis C virus disease is transmitted through blood. Chronic hepatitis C causes liver damages such as liver fibrosis, liver cirrhosis, and hepatocellular carcinoma. It is estimated that there are approximately 20 000 - 30 000 patients infected with hepatitis C virus in Finland. For many years pegylated interferon and ribavirin has been standard of care. However standard of care causes side effects and an adequate treatment response can't be achieved with it. There have been effective direct-acting antivirals available on market which are directed against structural proteins and enzymes of the virus from 2014 onward. These second generation direct-acting antivirals are effective, safe and well tolerated. The only disadvantage is the high price of these medicines which restricts them for severe liver damage patients. More information about cost-effectiveness of second generation direct-acting antivirals is needed to support the decision making. The aim of this master thesis is to describe current care, guidelines, and costs of hepatitis C in Finland. Thesis also describes the principles of economic evaluation and systematic literature review. The purpose of the thesis is to assess cost-effectiveness of second generation direct-acting antivirals versus standard of care in treating of hepatitis C by means of systematic literature review and evaluate the quality of cost-effectiveness analyses. Previously published studies were used to analyze the cost-effectiveness of second generation direct-acting antivirals. In total of 435 references were found through systematic literature search. In addition, two studies were found from the bibliographies of already included studies. Altogether 26 studies were included in the systematic review of which 25 were original studies and one was previously published systematic literature review. The most relevant data of the studies was gathered and analyzed. The quality of the studies was assessed by using three checklists. It is difficult to make conclusions about cost-effectiveness of second generation direct-acting antivirals based on previously published reviews because only one review was found through systematic literature search. The incremental cost-effectiveness ratio (ICER) of second generation direct-acting antivirals varied between dominance and 1 135 655 € /QALY compared to standard of care. When compared to another second generation direct-acting antiviral, ICER of second generation direct-acting antivirals varied between dominance and 65 281 € /QALY. It was also analyzed how stage of liver damage affects the incremental costeffectiveness of second generation direct-acting antivirals. The ICER of second generation direct-acting antivirals was between 299 € - 85 195 € /QALY when treating patients with cirrhosis. When treating non-cirrhotic patients, the ICER of second generation direct-acting antivirals was between 2182 € - 177 679 € /QALY.The connection between funder of the study and the ICER of second generation direct-acting antivirals was also analyzed. The ICER was 1717 € - 86 056 € /QALY in studies funded by pharmaceutical company. The ICER was 299 € - 1 135 655 € /QALY in studies funded by other party. Based on the results of the thesis second generation direct-acting antivirals might be cost-effective compared to current standard of care in treating hepatitis C. The cost-effectiveness ratio of second generation direct-acting antivirals is lower in cirrhotic patients than in non-cirrhotic patients. The incremental cost-effectiveness ratio is lower when pharmaceutical company funds a study. The quality of the cost-effectiveness analyses included in the thesis varied greatly which makes it difficult to draw conclusions and interpretate the results. This study has several strengths. First, literature search was conducted systematically and transparently. Second, quality of the reviewed studies included was assessed by care. Finally, reporting of the results is transparent and repeatable. The study has also some limitations. Selection of the reviewed studies, data extraction and quality assessment of the studies was conducted by one person which may increase the possibility of human error.

Yhteystiedot

HELSINGIN YLIOPISTO