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Aim: To evaluate the clinical and economic effectiveness of dapagliflozin in patients with chronic heart failure (CHF) with reduced left ventricular ejection fraction (HFrEF) in the Russian Federation in various subgroups of standard therapy for CHF.
Materials And Methods: A clinical and economic analysis of the use of the drug dapagliflozin in addition to standard therapy was carried out in comparison with standard therapy in various subgroups of standard therapy for HFrEF using a modeling method. Cost calculations were carried out in a mathematical model adapted to the healthcare conditions of the Russian Federation by using Russian cost indicators and characteristics of the patient population.
Results: The present study demonstrates that the addition of dapagliflozin is beneficial in terms of clinical and cost-effectiveness, regardless of the initial regimen (angiotensin receptor-neprilysin inhibitors [ARNI] or angiotensin-converting enzyme inhibitors [ACEi]/angiotensin II receptor blockers [ARB]) of standard drug therapy for HFrEF and in all cases leads to an increase in life expectancy, a decrease in the number of hospitalizations and emergency visits due to CHF, as well as cardiovascular mortality. The obtained values of added value per additional year of life in all cases are significantly lower than the willingness-to-pay threshold, which indicates the clinical and economic effectiveness of the strategy of prescribing dapagliflozin as part of standard therapy for patients with HFrEF. In the case of adding dapagliflozin the values of the additional cost of an added year of life in the 3 considered standard therapy options (ARNI or ACEi/ARB, only ACEi/ARB and only ARNI) were 291,256, 279,571 and 338,374 rubles respectively. Thus, the scenario of using dapagliflozin with standard therapy, which included only ACEi/ARB, is characterized by the lowest additional cost and has the best clinical and economic characteristics. At the same time the scenario of use with standard therapy, which included only ARNI, is characterized by the highest value of the additional value of the added year of life.
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http://dx.doi.org/10.26442/00403660.2024.08.202915 | DOI Listing |
Expert Rev Med Devices
December 2024
NorthShore University Health System, Evanston, IL, USA.
Introduction: Proactive esophageal cooling reduces injury during radiofrequency (RF) ablation of the left atrium (LA) for the treatment of atrial fibrillation (AF). New catheters are capable of higher wattage settings up to 90 W (very high-power short duration, vHPSD) for 4s. Varying power and duration however does not eliminate the risk of thermal injury.
View Article and Find Full Text PDFExpert Opin Drug Saf
December 2024
Medical Genetics 8812, University of Alberta, Edmonton, AB, Canada.
Introduction: Duchenne muscular dystrophy (DMD) is a severe X-linked disorder characterized by progressive muscle weakness and eventual death due to cardiomyopathy or respiratory complications. Currently, there is no cure for DMD, with standard treatments primarily focusing on symptom management. Using immunosuppressive measures and optimized vector designs allow for gene therapies to better address the underlying genetic cause of the disease.
View Article and Find Full Text PDFFront Public Health
December 2024
Medical Faculty Belgrade, Gynecology Obstetric University Clinic Narodni Front, Belgrade, Serbia.
Introduction: Low birth weight, defined as a birth weight below 2,500 g, represents a significant public health concern with a multifactorial risk dimension. Socio-demographic factors and individual characteristics of women and their social environment could influence low birth weight. This study aimed to analyze the association between the socio-demographic and reproductive characteristics of women living in low-income households and low birth weight in Serbia, Kosovo, and Montenegro.
View Article and Find Full Text PDFAfr J Emerg Med
March 2025
Department of Emergency Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
Background: Timely vascular access forms a necessary part of patient management in the Emergency Department (ED). Factors such as hypotension, intravenous drug use, obesity, dark skin, patients at extremes of age, and patients with multiple injuries may make peripheral intravenous cannulation difficult. The intraosseous route remains a suitable alternative for emergency circulatory access.
View Article and Find Full Text PDFInt J Gen Med
December 2024
Department of Tuberculosis, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.
Purpose: Tuberculosis meningitis (TBM) has emerged as the most lethal type of disease. The prognosis of meningitis is often related to disease severity and early therapeutic intervention.
Methods: Patients were screened for primary TBM and received a quadruple regimen comprising isoniazid (standard dose of 300 mg/day and high dose of 600 mg/day), rifampin, ethambutol, and pyrazinamide.
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