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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Hur effektivt är alemtuzumab respektive daclizumab vid behandling av multipel skleros? / How effective is alemtuzumab and daclizumab respectively as a treatment for multiple sclerosis?

Limani, Nereida January 2017 (has links)
Background: Multiple sclerosis (MS) is an autoimmune disease which attacks the central nervous systems (CNS) white substance. The damages cause MS-plaques which lead to disability in the CNS. There are currently around 20,000 people in Sweden who live with the diagnosis and every year another 1,000 people develop MS. It is twice as common for women to suffer from MS in comparison with men. Objective: The purpose of the study was to investigate the efficacy and safety of the alemtuzumab and daclizumab infusion drugs. Methods: This work is a literature study based on 6 scientific articles. Results: Based on at least one of the studied parameters, which are improvement in Expanded Disability Status Scale (EDSS), annual relapse rate and sustained accumulation of disability (IFS), showed that all four studies on alemtuzumab provided a higher therapeutic effect than IFN-β-1a. The two studies on daclizumab showed in one article in comparison with placebo a better treatment effect. The article comparing daclizumab with IFN-β-1a did not show major differences between the preparations but a reduced annual relapse rate was observed. Conclusion: The studies showed that both alemtuzumab and daclizumab yield better effect than IFN-β-1a and placebo. Treatment with alemtuzumab gave slightly better results in persistent worsening of the disease (IFS) compared with daclizumab, IFN-β- 1a and placebo. Patients who were treated with alemtuzumab had worse adverse events in comparison to the group of patients who were treated with IFN-β-1a. This shows that the safety of treatment with alemtuzumab was lower in comparison to treatment with IFN-β-1a. Most fatal outcomes were found during treatment with alemtuzumab. These aspects makes one consider whether alemtuzumab may or may not be the best treatment option. Also daclizumab had some serious side effects, but those did not occur as much as with alemtuzumab treatment. IFN-β-1a has been a safer drug to use as compared to alemtuzumab and dalclizumab. On the other hand, the mechanism of action differs between the three drugs, which means that these can be tailored more individually to MS-affected patients and a more individual-based drug treatment may be possible.
2

Interleukin-2-Rezeptor-Antagonisten für pädiatrische und adulte Lebertransplantatempfänger: Systematische Reviews und Meta-Analysen kontrollierter Studien / Interleukin-2 receptor antagonists for pediatric and adult liver transplant recepients: systematic reviews and meta-analyses of controlled studies

Crins, Nicola Dominique 16 November 2016 (has links)
Interleukin-2-Rezeptor-Antikorper (IL-2RA) sind monoklonale Anti-IgG-Antikörper, die den Interleukin-2-Rezeptor aktivierter T-Zellen blockieren und so zu einer signifikanten Reduktion von akuten Abstoßungsreaktionen (AR) nach Nierentransplantation führen. Ziel dieser Arbeit ist die Durchführung einer Meta-Analyse aller verfügbaren kontrollierten Studien, die Erwachsene und Kinder nach primarer Lebertransplantation mit einer Induktionstherapie mit IL-2RA behandelten und diese mit Placebo oder keiner Heilbehandlung verglichen. Die Meta-Analyse soll zeigen, dass durch IL-2RA-Gabe die AR, SRAR (steroidresistente AR), Tod des Patienten (D), Transplantatverlust (GL) sowie CNI- und Steroid-bedingte Nebenwirkungen durch Dosisreduktion signifikant reduziert werden. Sechs Studien mit pädiatrischen und 20 Studien mit adulten Transplantatempfängern erfüllten die Einschlusskriterien. Die Analyse der Endpunkte wurde mit dem Modell mit zufälligen Effekten durchgeführt. Die IL-2RA-Induktionstherapie kann als sicher und ohne signifikante Nebenwirkungen für mindestens zwölf Monate bei Patienten nach Lebertransplantation beurteilt werden. IL-2RA reduziert signifikant die AR bei pädiatrischen (RR 0,38 CI [0,22-0,66]; p=0,0126; NNT=4) und adulten Patienten (RR 0,83 CI [0,74-0,93]; p=0,0007; NNT=18) nach Lebertransplantation und SRAR bei adulten Patienten (RR 0,66 CI [0,48-0,91]; p=0,011; NNT=29). D und GL werden reduziert. In adulten Studien der Vergleichsgruppe delayed/reduced CNI wurden eine signifikante Reduktion der gepoolten renalen Dysfunktionen (RR 0,46; CI [0,27-0,78]; p=0,004; 5 Kohorten), des Serum-Kreatinin (MD -0,05; [0,11-0,01]; p=0,03; 3 Kohorten) sowie eine signifikante Steigerung der eGFR beobachtet. Bei adulten Patienten der Vergleichsgruppe no/low steroids zeigte sich eine signifikante Reduktion des PTDM (RR 0,42; CI [0,31-0,55]; p<0,0001; NNT=12) und des HTN (RR 0,49; CI [0,25-0,96]; p=0,04; NNT=11).

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