Lenvatinib in the treatment of unresectable hepatocellular carcinoma: a systematic review of economic evaluations.

PURPOSE: This aim of this study was to conduct a systematic review of economic evaluations comparing lenvatinib to other vascular endothelial growth factor (VEGF) inhibitors and other treatment options in the management of unresectable hepatocellular carcinoma (uHCC). METHODS: A comprehensive literature search was conducted using highly sensitive search syntax. The titles and abstracts of all records were studied and screened to identify eligible economic evaluations. To enable comparison across different countries, the results of economic evaluations make it possible to compare, the costs and ICER of all studies were converted into 2022 US dollars, and a 3% annual increase for inflation was applied. The quality of the studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. This study is conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS: Lenvatinib was found to be cost-effective (ICER = dominant) compared to most drugs in the included studies, except in studies where it was compared with donafenib or when the price of sorafenib was significantly discounted (e.g., with a 90% discount, the value of ICER was + 104,669 USD). CONCLUSION: Lenvatinib was generally cost-effective in most studies, but not compared to donafenib or sorafenib (if the price sorafenib was significantly discounted).

Nanobiotechnological approaches in antinociceptive therapy: Animal-based evidence for analgesic nanotherapeutics of bioengineered silver and gold nanomaterials.

Pain management is a major challenge in healthcare systems worldwide. Owing to undesirable side effects of current analgesic medications, there is an exceeding need to develop the effective alternative therapeutics. Nowadays, the application of nanomaterials is being highly considered, as their exceptional properties arising from the nanoscale dimensions are undeniable. With the increasing use of metal NPs, more biocompatible and costly methods of synthesis have been developed in which different biological rescores including microorganisms, plants and algae are employed. Nanobiotechnology-based synthesis of nanosized particles is an ecological approach offering safe production of nanoparticles (NPs) by biological resources eliminating the toxicity attributed to the conventional routes. This review provides an assessment of biosynthesized silver nanoparticles (AgNPs) and gold nanoparticles (AuNPs) as antinociceptive agents in recent studies. Living animal models (mice and rats) have been used for analyzing the effect of biogenic NPs on decreasing the nociceptive pain utilizing different methods such as acetic acid-induced writhing test, hot plate test, and formalin test. Potent analgesic activity exhibited by green fabricated AgNPs and AuNPs represents the bright future of nanotechnology in the management of pain and other social and medicinal issues followed by this unpleasant sensation. Moreover, there NPs showed a protective effects on liver, kidney, and body weight in animal models that make them attractive for clinical studies. However, further research is required to fully address the harmless antinociceptive effect of NPs for clinical usage.

Nanobiotechnological approaches in anticoagulant therapy: The role of bioengineered silver and gold nanomaterials.

Nanotechnology is a novel area that has exhibited various remarkable applications, mostly in medicine and industry, due to the unique properties coming with the nanoscale size. One of the notable medical uses of nanomaterials (NMs) that attracted enormous attention recently is their significant anticoagulant activity, preventing or reducing coagulation of blood, decreasing the risk of strokes, heart attacks, and other serious conditions. Despite successful in vitro experiments, in vivo analyses are yet to be confirmed and further research is required to fully prove the safety and efficacy of nanoparticles (NPs) and to introduce them as valid alternatives to conventional ineffective anticoagulants with various shortcomings and side-effects. NMs can be synthesized through two main routes, i.e., the bottom-up route as a more preferable method, and the top-down route. In numerous studies, biological fabrication of NPs, especially metal NPs, is highly suggested given its eco-friendly approach, in which different resources can be employed such as plants, fungi, bacteria, and algae. This review discusses the green synthesis and characterization of silver nanoparticles (AgNPs) and gold nanoparticles (AuNPs) as two of the most useful metal NPs, and also their alloys in different studies focussing on their anticoagulant potential. Challenges and alternative approaches to the use of these NPs as anticoagulants have also been highlighted.

Exploring the biological application of Penicillium fimorum-derived silver nanoparticles: In vitro physicochemical, antifungal, biofilm inhibitory, antioxidant, anticoagulant, and thrombolytic performance.

This study showed the anti-candida, biofilm inhibitory, antioxidant, anticoagulant, and thrombolytic properties of biogenic silver nanoparticles (AgNPs) fabricated by using the supernatant of Penicillium fimorum (GenBank accession number OQ568180) isolated from soil. The biogenic AgNPs were characterized by using different analytical techniques. A sharp surface plasmon resonance (SPR) peak of the colloidal AgNPs at 429.5 nm in the UV-vis spectrum confirmed the fabrication of nanosized silver particles. The broth microdilution assay confirmed the anti-candida properties of AgNPs with a minimum inhibitory concentration (MIC) of 4 µg mL-1. In the next step, the protein and DNA leakage assays as well as reactive oxygen species (ROS) assay were performed to evaluate the possible anti-candida mechanisms of AgNPs representing an increase in the total protein and DNA of supernatant along with a climb-up in ROS levels in AgNPs-treated samples. Flow cytometry also confirmed a dose-dependent cell death in the AgNPs-treated samples. Further studies also confirmed the biofilm inhibitory performance of AgNPs against Candia albicans. The AgNPs at the concentrations of MIC and 4*MIC inhibited 79.68 ± 14.38% and 83.57 ± 3.41% of biofilm formation in C. albicans, respectively. Moreover, this study showed that the intrinsic pathway may play a significant role in the anticoagulant properties of AgNPs. In addition, the AgNPs at the concentration of 500 µg mL-1, represented 49.27%, and 73.96 ± 2.59% thrombolytic and DPPH radical scavenging potential, respectively. Promising biological performance of AgNPs suggests these nanomaterials as a good candidate for biomedical and pharmaceutical applications.