Coherent magnetization precession in ferromagnetic (Ga,Mn)As induced by picosecond acoustic pulses

We show that the magnetization of a thin ferromagnetic (Ga,Mn)As layer can be modulated by picosecond acoustic pulses. In this approach a picosecond strain pulse injected into the structure induces a tilt of the magnetization vector M, followed by the precession of M around its equilibrium orientation. This effect can be understood in terms of changes in magneto-crystalline anisotropy induced by the pulse. A model where only one anisotropy constant is affected by the strain pulse provides a good description of the observed time-dependent response.Comment: 13 pages, 3 figure

Dupilumab in the treatment of severe non-control broncial asthma — economic aspects

Severe non-control Bronchial Asthma (BA) is a sufficient social problem with decreasing of quality of life, high index of disability and death. New biological drug — dupilumab — would improve the situation.Materials and methods. Markov’s model has been used for efficacy comparison of dupilumab and omalizumab with cycles between remissions and exacerbations of BA with interval as 4 weeks. Target population was 287naive patients per year which can be treated with dupilumab instead omalizumab. Non-direct comparison has shown that clinical efficacy of dupilumab was higher vs omalizaumab (prevention of 4,2 and 2,4 exacerbations/year accordingly, p<0,05). Horizon of budget impact analysis (BIA) was 3 years, and discounting rate was 5 %. Only direct costs were used (drugs’ costs, expenditures due to hospitalizations and out-patients department treatment).Results. Cost of dupilumab was 1 013 012 RUR/patient/year, that less on 182,2 thsd RUR than in omalizaumab case (16,04 %). Dupilumab can reduce expenditures in frames of Governmental Guarantees Program on 58,3 mln. RUR for the first year, and 162,2 mln. RUR during 3 —years horizon (16,13 % saving). Direct costs reduction with dupilumab can explain by less expenditures on the cours of therapy as well as decreasing cost of hospitalization and out-patients cure.Conclusion. Hypothesis about possibilities of dupilumab inclusion into reimbursement programs has been confirmed from clinical-economic point of view

Multicriteria analysis of the assortment of innovative drugs in oncohematology as a tool for supporting decision-making in the field of drug provision

On the basis of multicriteria analysis, a pilot complex system for evaluating medicinal products (MP) used in the therapy of oncohematological diseases has been developed. The obtained results allow to rank MPs by priority of choice when making decisions on procurement of drugs or inclusion in MP lists in the framework of programs of preferential drug provision of the population. It has been shown that, according to the set of criteria, ibrutinib in treatment of chronic lymphocytic leukemia (CLL) has the highest priority, followed by obinutuzumab (CLL treatment) and ruxolitinib (treatment of myelofibrosis)

Pharmacoeconomic analysis of anti-angiogenic therapy for diabetic macular edema

Te purpose of the study is to assess the economic consequences of the use of various anti-VEGF drugs in patients with diabetic macular edema (DME).Materials and methods. Te cost–effectiveness analysis and budget impact analysis was conducted from the payer perspective (health insurance system).Results. In accordance to the results from RCT (Protocol T) aflibercept required a lower number of intravitreal injections (IVI) and laser coagulations for frst year and it has tendency for lower number of IVI for the second year of treatment that resulted in lower costs for aflibercept therapy by 122,819 rubles (12.7 %) per patient within frst 2 years (1st year – 66,632 rubles, 2nd year – 61,186 rubles) in comparison with ranibizumab. Te cost–effectiveness analysis showed that aflibercept is a “cost–effective” method of treating patients with DME compared to ranibizumab in Pro Re Nata (PRN) mode. Te budget impact analysis has shown savings for the health insurance system (12 million rubles) for the analyzed patient cohort (n = 100) with aflibercept in 2 years (1st year – 6.163 million rubles; 2nd year – 6.119 million rubles). Te analysis of “lost opportunities” in a cohort of 100 patients showed that the use of aflibercept in DME can free up to 216 hospitalizations within 2 years (109 cases in the 1st year and 107 in the 2nd year). As a result, about 14 patients with DME can be additionally treated with aflibercept for two years within a fxed budget.Conclusion. Treatment of DME with aflibercept can save resources of health insurance system compared to use of ranibizumab

Individualisation of basal insulin therapy of type 2 diabetes: evidence from large randomized controlled trials

Initiation of insulin therapy with basal insulin analogues has become the standard of care for type 2 diabetes mellitus (T2DM). Timely administration of insulin allows not only to slow down the progression of type 2 diabetes, but also to reduce the frequency and severity of complications associated with it. This paper reviews the efficacy and safety of the use of the latest basal insulin analogues in type 2 diabetes from the perspective of current clinical guidelines, and also reviews updated data on the efficacy and safety of therapy by various members of the class. In this paper a review of the efficacy and safety of latest basal insulin analogues use in T2DM from the standpoint of current clinical guidelines has been carried out, and updated data on the efficacy and safety of therapy by various members of the class have been reviewed, taking into account their impact on the risk of hypoglycemia and glycemic variability. The available data indicate that insulin degludec 200 U/mL may be the drug of choice for those at high risk of developing severe forms of hypoglycemia. Since severe hypoglycemia and high glycemic variability are important risk factors for cardiovascular events and mortality, it has been shown that a differentiated approach to insulin therapy in the treatment of T2DM is currently advisable, taking into account the effect on the risk of hypoglycemia and glycemic variability

Evaluation of the health care budget impact of secukinumab treatment in patients with ankylosing spondylitis

Objective: clinical and economic analysis of including of secukinumab (SEC) in the essential drug list (EDL) and Federal Reimbursement (ONLS) to ensure the availability of the drug to patients with ankylosing spondylitis (AS) at the expense of health. Material and methods. A budget impact analysis was used. Only cost of drugs was taken into account. Adalimumab (ADA) and infliximab (INF) were used for comparison. Basing on the calculated number of patients treated with these drugs in 2016 from the budget of health care system impact on 3-years budgets of State Guarantee Program (SGP) and ONLS was analyzed. The analysis scenario was based on the replacement of ADA and INF with SEC. Results. Expenditure of a 3-year therapy cycle with SEC amounted to 1.703 million rubles, which was 41.6% less than that with ADA (2.917 million rubles) and 57.7% less than that with INF (4.022 million rubles) in the same period. The budget impact analysis to estimate the cost of SGP demonstrated that the use of SEC during a 3-year period would result in a reduction in expenses by 51.2% (saving of 3.8 billion rubles). When SEC is used within the ONLS, its cost during 3 years will be reduced by 51.9% (savings of 1.9 billion rubles). Conclusion. The inclusion of SEC in EDL and ONLS is appropriately and economically justified, as it enables a substantial reduction in the expenditure of health care budgets to treat patients with AS and to maintain the clinical effectiveness of therapy

Ultrafast changes of magnetic anisotropy driven by laser-generated coherent and noncoherent phonons in metallic films

Ultrafast optical excitation of a metal ferromagnetic film results in a modification of the magnetocrystalline anisotropy and induces the magnetization precession. We consider two main contributions to these processes: an effect of noncoherent phonons, which modifies the temperature dependent parameters of the magnetocrystalline anisotropy and coherent phonons in the form of a strain contributing via inverse magnetostriction. Contrary to earlier experiments with high-symmetry ferromagnetic structures, where these mechanisms could not be separated, we study the magnetization response to femtosecond optical pulses in the low-symmetry magnetostrictive galfenol film so that it is possible to separate the coherent and noncoherent phonon contributions. By choosing certain experimental geometry and external magnetic fields, we can distinguish the contribution from a specific mechanism. Theoretical analysis and numerical calculations are used to support the experimental observations and proposed model

Lipid profile of patients with arterial hypertension who underwent COVID-19: possibilities of drug therapy/ LEADER

Aim. To study the dynamics of the lipid profile of hypertensive patients with dyslipidemia who underwent COVID-19.Material and methods. Hypertensive patients with dyslipidemia who underwent COVID-19 [n=126; 58 men and 68 women; median age 60 (56.0; 65.5) years] examined. Patients were included into two groups: group 1 (n=64) received a single pill combination of lisinopril + amlodipine + rosuvastatin; 2 groups (n=62) continued the previous drug treatment. Clinical, demographic, office blood pressure (BP), total cholesterol (TC), low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol, triglycerides, C-reactive protein (CRP) levels were assessed in all patients in 3 visits within 24 weeks.Results. The groups did not differ in prior antihypertensive therapy (except for more frequent use of angiotensin II receptor blockers in group 2, p<0.05), lipid profile and blood pressure parameters at study entry. A decrease in systolic (by 9.5%) and diastolic blood pressure (by 12.1%) after 24 weeks was found in group 1 compared with 4.29% and 5.56%, respectively, in group 2 (p<0.05). A decrease in the level of total cholesterol by 14.5% and LDL-c by 31.4% after 24 weeks was found in group 1 compared with 11.2% and 9.7%, respectively, in group 2 (p<0.05). The level of CRP during the observation period decreased by 53.7% in group 1 versus 43.4% in patients of group 2 (p<0.05).Conclusion. The single pill combination of lisinopril/amlodipine/rosuvastatin in hypertensive patients with dyslipidemia who underwent COVID-19 led to an improvement in lipid profile and blood pressure control

Economic evaluation of the fixed combination of insulin glargine and lixisenatide in Diabetes Mellitus type 2

Aim: a prognosis of clinical-economic efficacy of the fixed combination of insulin glargine and lixisenatide (Soliqua SoloStar®) in comparison with standard therapy with focus on micro- and macrovascular complications of Diabetes Mellitus type 2 (T2DM) in the real practice.Materials and Methods. Model of Burden of T2DM has been created in Microsoft Excel 2010 program. Direct (costs of medicines, treatment of main T2DM complications — myocardial infarction, stroke, etc.) as well as indirect costs (GPD losses, disability related payments, etc.) were calculated. Complications’ rate was took from Federal Diabetes Register. Influence on Burden of T2DM was tested with the additional model which can calculate expenditures with different drugs including Soliqua SoloStar® usage.Results. Direct medical costs with Soliqua SoloStar® usage were less in compare with insulin glargine 100 UI/ml on 23,5 % per year due to decreasing level of severe hypoglycemia and possible protective effect on complications of T2DM (better control). Total expenditures for Soliqua SoloStar® were less on 2,5 % annually, in the same time insulin glargine led to total cost increase by 18,4 % per year. So, difference between expenditures in case of Soliqua SoloStar® were less on appr 21 % vs insulin glargine 100 UI/ml. Budget saving is expected as 6,78 ml RUR per year / 1 000 patients in case of Soliqua SoloStar® usage.Conclusion. Soliqua SoloStar® has economic benefits due to T2DM complications and severe hypoglycemia reduction risks