and Ն9%, respectively. Compared with placebo, more patients achieved HbA1c Ͻ7% (39.4% vs 24.4%) and Ͻ8% (79.5% vs 60.6%) and fewer patients remained at or worsened to HbA1c Ͼ9% (4.2% vs 13.9%) with dapagliflozin. CONCLUSIONS: Dapagliflozin 10 mg/day reduced HbA1c across all baseline HbA1c categories; greater reductions were seen in patients with higher baseline HbA1c. Substantially more patients attained HEDIS HbA1c categories of Ͻ7% and Ͻ8% and substantially fewer patients remained at or worsened to HbA1c Ͼ9% with dapagliflozin, compared with placebo. Collectively, dapagliflozin provided better glycemic control than placebo over a range of HbA1c levels.
OBJECTIVES:To evaluate the long-term clinical and economic consequences of saxagliptin in comparison with sulphonylurea available in the Russian market.
METHODS:The analysis is based on the Cardiff Long Term Model (Clarke et al. 2004). Three scenarios were developed and tested. Scenario 1 "trial based scenario" (S1) the active treatment is saxagliptin (Onglyza®) added to metformin (MET), which is compared to MET plus sulphonylurea (SU); input data are derived from study D1680C00001 (Goke et al. 2010. Scenario 2 "real world scenario" (S2). Efficacy and safety data taken from study D1680C00001, the cohort was taken from the Russian Federal Diabetes Patient Register, time horizon was set to 40 years, HbA1c threshold of 9.0% was assumed. Scenario 3 "MET monotherapy scenario" (S3). Efficacy and safety data taken from a study of DeFronzo et al. 2009. Patient demographic characteristics were the same as in Scenario 2; time horizon -nine years as in the base case scenario 1. The cost-effectiveness analysis was performed from the government health care system's perspective. The costs applied were based on prices listed in the essential drug list (MoH 2010) and official standards of treatment developed by expert groups at the Ministry of Health level (Russian Federation). RESULTS: In S1 -MET plus saxagliptin was associated with an incremental costeffectiveness ratio (ICER) of Russian Roubles (RUB) 38,840 per QALY gained, and RUB 7,142,690 per life year gained (LYG) versus SU. In S2 -ICER of RUB 104,153 per QALY gained and RUB 9,884,121 per life year. In S3 -ICER resulted in RUB 20,353,081 per QALY and RUB 29,044,346 per life year gained. CONCLUSIONS: In both scenarios (1 and 2), assuming a willingness to pay threshold of RUB 800'000, saxagliptin would be considered cost-effective in the Russian setting.
One of the main areas of treatment for pneumonia caused by the new COVID-19 coronavirus infection is the use of drugs aimed at fighting the cytokine storm, including corticosteroids. The purpose of this study was to study the effectiveness of the use of methylprednisolone at different stages of inpatient care – in the intensive care unit (ICU) and in therapeutic departments. Therapy with methylprednisolone was performed for 54 patients, which accounted for 9% of the total number of hospitalized patients in the Federal State Budgetary Institution «Federal center of brain research and neurotechnologies» of the Federal Medical Biological Agency. In the ICU, therapy was performed for 28 patients, in therapeutic departments for 26 patients, the control group consisted of 14 patients. Methylprednisolone was perfused in a daily dose of 250 mg continuously intravenously for three days, the total dose was 750 mg. The results of the study showed a significant decrease in the mortality rate in the group that was treated with methylprednisolone in therapeutic departments (7.7%) compared to the group that was treated in the ICU (67.9%) and the control group (42.9%, p<0.001). Also, the group with therapy at therapeutic departments was characterized by a lower frequency of mechanical ventilation (in 2 (7,7%), 20 (71,4%) and 7 (50%) cases, respectively, p<0.001). Thus, the introduction of methylprednisolone in the therapeutic department as a anti-inflammatory therapy contributes to a reduction in hospital mortality rates and the frequency of mechanical ventilation use for patients with pneumonia caused by a new COVID-19 coronavirus infection.
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