analyses (DSA and PSA) were conducted. Results: Over a lifetime horizon, treating moderate-to-severe active UC with tofacitinib resulted in additional quality-adjusted life-years (QALYs) and lower total costs compared to vedolizumab (0.018; V6,408) and infliximab (biosimilar) (0.009; V3,031), hence, tofacitinib was estimated to dominate over both comparators. DSA showed model results were mostly influenced by differences in treatment efficacy from the NMA and target patient population. PSA confirmed robustness of findings below a threshold of V34,000 in 100% and 98% of the simulations comparing tofacitinib to vedolizumab and infliximab respectively. Conclusions: The results of the analysis suggest that in the Greek setting, tofacitinib could be considered a cost-effective (dominant) treatment option for the treatment of patients with moderate-to-severe active UC.

IntroductionColorectal cancer (CRC) is the third most common malignant neoplasm among men and the second most common among women. According to the World Cancer Report, the number of people suffering from this disease is growing steadily. In 2012, there were more than 1.36 million new cases of CRC, and approximately 694,000 people died from this disease worldwide.MethodsA sensitive literature search identified 12 relevant publications, including: a CORRECT phase III study assessing the effect of regorafenib in patients with metastatic CRC that continued to progress despite using all standard treatment methods; a CONCUR Phase III study evaluating the clinical effect of regorafenib in Asian patients with metastatic CRC; a CONSIGN study conducted after the CORRECT and CONCUR studies that assessed the safety profile of regorafenib prior to market entry; and various systematic reviews evaluating the safety of regorafenib.ResultsThe efficacy and safety of regorafenib for treating patients with metastatic CRC was evaluated in two major clinical studies: CORRECT and CONCUR. Although the studies were randomized, double-blind, and placebo-controlled, they were conducted in different patient populations. Before treatment with regorafenib, patients received, depending on the country, fluoropyrimidines, oxaliplatin, irinotecan, or bevacizumab, and patients with the wild-type KRAS gene also received cetuximab and panitumumab. Results from both studies indicated that regorafenib had a clinically significant positive effect on rates of progression-free survival and overall survival in patients with treatment-resistant metastatic CRC.ConclusionsRegorafenib can be recommended as a monotherapy for resistant metastatic CRC when there are no contraindications to use. Considering the safety profile of regorafenib, further research is needed to determine the best dosage of regorafenib and the most appropriate clinical and molecular biomarkers for determining which patients would benefit most from this treatment.

A study was conducted to assess the clinical and economic effectiveness of vildagliptin in adults with type 2 diabetes mellitus (T2DM) with poor glycemic control against the metformin monotherapy.Materials and methods: 280 sources were identified in accordance with the search strategy; 40 sources were subjected to critical analysis, of which 22 full-text publications were included in the present study.Results and discussion: Significant advantages of the use of vildagliptin in combination with metformin in improving glycemic control, regardless of the initial level of glycosylated hemoglobin (HbA1c), age or body mass index (BMI) compared with other dipeptidyl peptidase-4 inhibitors, were found; Combination therapy using 50 mg of vildagliptin and metformin twice daily significantly reduced the mean baseline HbA1c (-0.7 to -0.9%) and fasting blood glucose levels (-1.4 to 0.1 mmol/l) compared with placebo, as well as with other dipeptidyl peptidase-4 inhibitors; this combination also led to the greatest increase in QALYs (0.18 over the life span) among dipeptidyl peptidase-4 inhibitors compared to treatment with a combination of metformin and glimepiride. Thus, the combination of metformin and vildagliptin gives advantages in efficiency and additional mechanisms of action, since it does not increase the risk of hypoglycemia and does not contribute to weight gain.Conclusion: Combination therapy using metmorfin and vildagliptin is more cost-effective, since it does not increase the risk of hypoglycemia and does not lead to increasing weight.

Aim: Clinical and economic evaluation of multi-matrix mesalazine 1200 mg compared with prolonged-release mesalazine at a dose of 500mg for the treatment of patients aged 18 years and older with the diagnosis of ulcerative colitis in the phase of exacerbation and remission.Material and methods: In accordance with the PICOS tool all published literature sources were identified in the electronic resources PubMed/Medline, DARE, Cochrane Central Register of Controlled Trials; the analysis included 5 studies with levels of evidence A and B. Calculations were performed in STATA and Microsoft Excel 10.0Results and discussion: According to the results of clinical and economic analysis, the strategy of using multi-matrix mesalazine is dominant in comparison with prolonged-release mesalazine as a first-line therapy and contributes to the increment of efficiency and leads to the minimization of costs to achieve a QALY unit per patient. Patients receiving multi-matrix mesalazine have a longer duration of remission and less likelihood of re-exacerbations. Conclusion:The use of multi-matrix mesalazine in comparison with prolonged-release mesalazine is an economically feasible alternative in the conditions of health care of the Republic of Kazakhstan -more effective and less financially costly, leading to potential budget savings.