Objectives: To analyze strategies of management of patients with diabetic polyneuropathy (DPN) considering the prevalence of DPN and diabetic foot (DF) in Russia. MethOds: The analysis was based on epidemiologic data on DPN and DF, and placebo controlled trials (ALADIN III for alpha-lipoic acid, and D. Ziegler study for Actovegin). Strategies with alpha-lipoic acid (1st group) and with Actovegin (2st group) were compared. In both cases, a 160-day course consisted of 20 days of parenteral injection in hospital, and 140 days of outpatient oral administration. Clinical outcomes and health care system costs were analyzed; cost-effectiveness ratio (CER) was calculated. The share of patients without DF was the main measure of effectiveness. Costs of the drugs, and hospital and outpatient treatment for budget holder were evaluated in two equal-sized groups. During the sensitivity analysis, clinical outcomes (risk of DF) were modeled with increment of 100 persons from 100 to 1000 patients. Results: The cohort of 10 000 patients with type 2 diabetes mellitus contained 6100 patients with DPN including 3700 patients with medium or severe stages. 2100 persons were in risk group for DF, including 1100 patients with high risk. 410 and 330 patients had DF in alpha-lipoic acid group and Actovegin group, respectively. The number of amputations in these groups was 70 and 56. The costs of 160-day treatment was 64,929.73 RUB in the 1st group, and 64,355.73 RUB in the 2nd group. The share of patients without DF was 70.02% and 62.7%. CER were 103,556.19 in alpha-lipoic acid group, and 91,910.50 in Actovegin group. The sensitivity analysis confirmed the advantage of Actovegin administration cOnclusiOns: The study showed clinical and pharmacoeconomic advantages of Actovegin administration in patients with DPN and DF. This strategy has more preferable CER and lower costs for public health care system.

and 31/03/2010, were identified through examination of electronic patient records. Exclusion criteria included patients with atrial flutter (AFl), or an ICD10 code indicating prior inpatient attendance for AF since 1995. Patient notes were reviewed manually and an anonymised data collection template completed by the clinician for analysis. RESULTS: Of the 126 patients meeting the inclusion criteria, the notes of 7 patients were unobtainable and 8 with a diagnosis of AFl were excluded. The majority of patients were symptomatic at presentation (56%) and less than half were male (41%). Within the study population, the frequency of patients with AF increased with age, peaking at 80-89 years (45% of the study sample). Method of admission was primarily through A&E or GP referral (48% each); with 50% of A&E admissions being for symptomatic AF, compared with 60% of those referred via a GP. Almost half the study population were recorded with "first detected AF" (47%); 67% of whom were symptomatic, compared to 47% being symptomatic in patients recorded as "not first detected AF". The majority of patients were reported to have 1 or 2 of the pre-defined co-morbidities of interest (29% each); one fifth had no co-morbidities. The most common co-morbidities were hypertension (51%), ischaemic heart disease (20%), heart failure (18%), diabetes (16%) and pulmonary disease (15%). CONCLUSIONS: Results from this study demonstrate the majority of patients presenting to secondary care with AF have multiple associated co-morbidities, which are known to influence the management and treatment strategy, and long-term complications. Further up-to-date epidemiological studies, which describe the history, management and prognosis of patients with AF, are required. OBJECTIVES:To analyze the add-on and switch patterns for patients who dispensed platelet aggregation inhibitors, excluding heparin (acetylsalicylic acid, clopidogrel, and dipyridamole) in the South-West region of Sweden. METHODS:This was a retrospective database study of medication utilization amongst patients from the South-West region of Sweden (1.5 million inhabitants). All patients who dispensed platelet aggregation inhibitors (B01AC), excluding heparin, from 2006 to 2009 were included in the study. A dispatch was classified as new, switch, add-on, or continuation. All dispatches were annotated, at the ATC level, as either new (no other anticoagulant within 105 days), add-on (another anticoagulant dispatched both before and after), switch (another anticoagulant dispatched before, but not after), or continuation (dispatched same ATC-code within 105 days). RESULTS: 163 330 patients had at least one B01AC filled prescription. The total number of dispatches for these patients were 3 327 499. 96% of all patients had been dispatched acetylsalicylic acid (ASA), 11% clopidogrel and 6% dipyridamole. ASA was dispatched as a new prescription in 17% of all dispatches, in Ͻ0.5% as add-on, Ͻ0.5% as switch, and in 83% as continuation. For clopidogrel the distribution was 17% (new), 4% (add-on)...

exponential model for initial response with a linear model for progression. Standard model diagnostics, including visual predictive checks, were applied to ensure model convergence and fit. Results: A total of 56 full-text studies were reviewed, 14 of which were included in the evidence synthesis (16 metformin study-arms, 100 datapoints and 4696 patients). The final model described HbA1c% as a function of time (up to 1.5 years), baseline HbA1c% and T2DM duration. An average amplitude of initial response of 1.54 was estimated, representing the maximal HbA1c% response to therapy. This response increases by 21% and 5% per unit increase in baseline HbA1c% and T2DM duration (years), respectively. The average time to reach 63% of the response amplitude was estimated at 2.30 months, decreasing by 19% for each unit increase in baseline HbA1c% and increasing by 11% for each extra year of T2DM duration. An average coefficient of failure (progression slope) of 0.63/year was estimated, decreasing by 0.21 per unit increase in baseline HbA1c% and increasing by 0.28 per 1-year increase in T2DM duration. Other covariates showed no major effect on model results. ConClusions: The developed model described the time course of HBA1c% well and has potential in the contextualization of information from future/other T2DM studies. PDB4 SyStematic Literature review anD inDirect treatment comPariSon of the efficacy of SemagLutiDe verSuS emPagLifLozin aS aDD-on to BaSaL inSuLin

To summarize prevalence rates globally for cardiovascular disease (CVD) in persons with type 2 diabetes (T2DM) published within the last 10 years (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017). MethOds: We searched Medline, Embase, and proceedings of scientific meetings to identify published studies documenting the prevalence of CVD among people with T2DM. Search terms included stroke, myocardial infarction, angina, heart failure, ischemic heart disease, cardiovascular disease, coronary heart/artery disease (CAD), atherosclerosis, and cardiovascular death. No restrictions were placed on country of origin or publication language. Two reviewers independently searched for articles and abstracted data, with results adjudicated through consensus. Data were summarized descriptively. Risk of bias was explored by applying the checklist from the STROBE Initiative.

No abstract