Socio-economic burden of chronic migraine in Russia

Introduction. Results of both clinical and epidemiological studies demonstrate a high frequency of work incapacity associated with headache, reduced socio-economic activity, low quality of life, greater number of comorbid diseases and mental disorders in patients with chronic migraine (CM) compared to those who suffer from episodic primary headache.Objectives. Te objective of the study was comparative assessment of the disease cost and clinical and economic consequences of using various therapeutic approaches for preventive treatment of CM from the societal perspective in the Russian Federation.Methods. Te following types of pharmacoeconomic analyses were used: disease cost analysis, budget effect analysis. Models based on literature data (Scenario No. 1) and based on expert opinion (Scenario No. 2) were constructed in parallel with subsequent interpretation and discussion of the results obtained. Direct and indirect costs were considered. Efcacy criteria were clinical outcomes of the use of therapeutic options in question — change in the frequency of use of migraine-associated aid: change in the frequency of use of emergency medical care; change in the frequency of inpatient treatment.Results. CM is a disease associated with a signifcant socio-economic burden: the cost of managing a target population of 1 470 840 patients with current distribution of therapeutic approaches can reach up to 402 569 527 778 RUB with clinical and economic modeling based on literature data, and 444 918 119 377 RUB with clinical and economic modeling based on expert opinion surveys. Indirect costs constitute a signifcant proportion of the socio-economic cost of CM, estimated at 61 995 589 503 RUB to 88 794 056 961 RUB. Te use of various therapeutic approaches for treating CM can reduce the cost of the disease for the target population. Te cost of managing one patient with Botox® per year (141 820 RUB) was up to 40 % lower than the cost of preventive treatment of a patient with CM with oral medications (202 894 RUB), up to 192 % lower than the cost of managing patients without preventive treatment (414 305 RUB). Te use of Botox is associated with signifcantly smaller indirect costs in comparison with the use of other therapeutic approaches in managing patients with CM

Therapy for memory and attention impairments in young patients

Objective. To study the efficacy and tolerance of tanakan in the treatment of mild cognitive impairment in young patients. Patients and methods. The study enrolled 30 patients whose mean age was 33.5±7.5 years. It used clinical neurological examination; a test for rating general condition, activity, and mood; studies to evaluate aural short-term and verbal short-term memories and to estimate the level of attention using Schulte's tables, and questionnaires for the rating of autonomic disorders and nocturnal sleep quality, those for the patient subjective assessment of treatment efficiency and for the recording of adverse reactions. Results. Tanakan therapy led to the normalized emotional status in the patients, improved nocturnal sleep, and reduced autonomic disorders. There was a tendency towards improvement of all characteristics of attention. Aural and verbal memories became better. Conclusion. Tanakan is an effective and safe drug to treat cognitive impairment at any age

MIGRAINE: BASIC PRINCIPLES OF TREATMENT AND PREVENTION

Modern recommendations for the migraine attack treatment and it's prophylaxis are analyzed in this review. Established, that acetylsalicylic acid, diclofenac potassium, ibuprofen, naproxen, paracetamol, metamizol and their combination with caffeine are drugs of the first choice for migraine attack treatment. Metoclopramide and domperidone are used to reduce nausea and vomiting. Also triptans are high effective drugs for migraine attack treatment. Metoprolol, propranolol, flunarizine, valproic acid can be used for migraine prophylaxis. Drugs of the second choice are: amitriptyline, venlafaxine, naproxen and bisoprolol.</p

Personalization of the use of non-steroidal anti-inflammatory drugs for musculoskeletal diseases. Resolution on the results of the Meeting of Experts of December 13, 2017

The personalization of therapy is one of the innovative approaches gaining an increasingly strong foothold in modern medicine, implying an individual approach to each patient, taking into account the individual characteristics of the patient and the specific clinical case. This same standpoint of personified therapy should be used to plan rational analgesic therapy, the most important component of managing patients with the most common and socially significant diseases, with conditions that have a significant impact on the patient’s quality of life and worsen the course of concomitant diseases. The Meeting of Experts of different specialties such as rheumatologists, neurologists, cardiologists and clinical pharmacologists considered the key aspects of the prescription of NSAIDs, the most widely used class of painkillers, including those used for the relief of musculoskeletal pain. It was noted that when choosing NSAIDs, the practitioner should take into account the diagnosis, the planned duration of  analgesic therapy, the intensity of pain, medical history data, the presence of comorbid diseases and risk factors for drug complications. There are different types of NSAIDs, some of which are most useful for urgent acute pain therapy (eg, ketoprofen), while others are most suitable for long-term pain management in chronic diseases (eg, etoricoxib). In any case, the practitioner should take into account the priority of patient safety and pay the utmost attention to the prevention of NSAIDassociated complications, and also keep in mind the duration of the specific drug administration permitted by the patient information leaflet. It was also noted that the launch of a new generic etoricoxib (Kostarox®) expands the possibilities of analgesic therapy for the Russian practitioners