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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rsp</journal-id><journal-title-group><journal-title xml:lang="ru">Научно-практическая ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Rheumatology Science and Practice</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1995-4484</issn><issn pub-type="epub">1995-4492</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/1995-4484-2018-157-163</article-id><article-id custom-type="elpub" pub-id-type="custom">rsp-2520</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Остеоартрит коленных суставов  и метаболический синдром:  новые подходы к терапии</article-title><trans-title-group xml:lang="en"><trans-title>KNEE OSTEOARTHRITIS AND METABOLIC SYNDROME: NEW APPROACHES TO THERAPY</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Алексеева</surname><given-names>Л. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Alekseeva</surname><given-names>L. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Людмила Ивановна Алексеева.</p><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>Lyudmila Alekseeva.</p><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><email xlink:type="simple">raell@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Таскина</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Taskina</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кашеварова</surname><given-names>Н. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Kashevarova</surname><given-names>N. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шарапова</surname><given-names>Е. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Sharapova</surname><given-names>E. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Аникин</surname><given-names>С. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Anikin</surname><given-names>S. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Стребкова</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Strebkova</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Короткова</surname><given-names>Т. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Korotkova</surname><given-names>T. А.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Раскина</surname><given-names>Т. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Raskina</surname><given-names>T. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>650029 Кемерово, ул. Ворошилова, 22а</p></bio><bio xml:lang="en"><p>22a, Voroshilov St., Kemerovo 650029</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зонова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zonova</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>630091 Новосибирск, Красный проспект, 52</p></bio><bio xml:lang="en"><p>52, Krasnyi Prospect, Novosibirsk 630091</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Оттева</surname><given-names>Э. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Otteva</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>680009 Хабаровск, ул. Краснодарская, 9</p></bio><bio xml:lang="en"><p>9, Krasnodarskaya St., Khabarovsk 680009</p></bio><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.A.Nasonova Research nstitute of Rheumatology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kemerovo State Medical University, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Novosibirsk State Medical University, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>КГБОУ ДПО «Институт повышения квалификации специалистов здравоохранения» Минздрава Хабаровского края</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute for Postgraduate Education of Health Professionals, Ministry of Health of the Khabarovsk Territory</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>07</day><month>05</month><year>2018</year></pub-date><volume>56</volume><issue>2</issue><fpage>157</fpage><lpage>163</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Алексеева Л.И., Таскина Е.А., Кашеварова Н.Г., Шарапова Е.П., Аникин С.Г., Стребкова Е.А., Короткова Т.А., Раскина Т.А., Зонова Е.В., Оттева Э.Н., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Алексеева Л.И., Таскина Е.А., Кашеварова Н.Г., Шарапова Е.П., Аникин С.Г., Стребкова Е.А., Короткова Т.А., Раскина Т.А., Зонова Е.В., Оттева Э.Н.</copyright-holder><copyright-holder xml:lang="en">Alekseeva L.I., Taskina E.A., Kashevarova N.G., Sharapova E.P., Anikin S.G., Strebkova E.A., Korotkova T.А., Raskina T.A., Zonova E.V., Otteva E.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://rsp.mediar-press.net/rsp/article/view/2520">https://rsp.mediar-press.net/rsp/article/view/2520</self-uri><abstract><p>Цель – изучить влияние диацереина (Диафлекс) на некоторые компоненты метаболического синдрома (МС) у больных с остеоартритом (ОА) коленного сустава.</p><sec><title>Материал и методы</title><p>Материал и методы. В многоцентровом открытом проспективном исследовании приняли участие 55 пациентов с ОА коленных суставов II–III стадии по Келлгрену–Лоуренсу и МС, с интенсивностью боли &gt;40 мм по визуальной аналоговой шкале, в возрасте от 45 до 74 лет, с длительностью заболевания от 1 года до 30 лет. Длительность терапии составила 6 мес: 1 мес – прием препарата Диафлекс в дозе 50 мг/сут, затем 5 мес по 50 мг 2 раза в день, последующие 3 мес – период наблюдения. Во время каждого визита проводилась оценка эффективности и безопасности лечения, кроме того, учитывались показатели биохимических анализов крови в начале и в конце терапии.</p></sec><sec><title>Результаты и обсуждение</title><p>Результаты и обсуждение. Статистически значимое улучшение показателей индекса WOMAC (всех его составляющих и суммарного значения), качества жизни по EQ-5D наблюдалось с первого месяца терапии и на протяжении всего периода наблюдения. При анализе по критерию OMERACT-OARSI показан высокий процент ответа на лечение: 92,5% пациентов в конце терапии и92,2%– через 3 мес после ее окончания. Нафоне лечения отмечено достоверное снижение индекса массы тела, уровней липопротеидов низкой плотности, триглицеридов, глюкозы, мочевой кислоты. Нежелательные реакции выявлены в небольшом числе случаев (5,5%).</p></sec><sec><title>Заключение</title><p>Заключение. Диафлекс является эффективным и безопасным препаратом при лечении ОА коленных суставов у пациентов с МС. На фоне терапии достаточно быстро и значимо уменьшаются болевой синдром и скованность, улучшается функциональное состояние суставов. Кроме того, плейотропные эффекты препарата позволяют не только эффективно снижать массу тела, но и, возможно, улучшать течение состояний, ассоциированных с МС, за счет наблюдаемых коррекций метаболических нарушений.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Objective</title><p>Objective: to investigate the effect of diacerein (Diaflex) on some components of metabolic syndrome (MS) in patients with knee osteoarthritis (OA).</p></sec><sec><title>Subjects and methods</title><p>Subjects and methods. The multicenter open-label prospective study covered 55 patients aged 45 to 74 years with Kellgren–Lawrence Stage II–III knee OA and MS, with a pain intensity of &gt;40 mm on a visual analogue scale, and with a disease duration of 1 to 30 years. The therapy duration was 6 months: Diaflex 50 mg/day for one month, then 50 mg twice daily for 5 months; the patients were followed up for the succeeding 3 months. During each visit, the efficiency and safety of treatment were evaluated; moreover, blood biochemical values were taken into account at the beginning and at the end of therapy.</p></sec><sec><title>Results and discussion</title><p>Results and discussion. There was a statistically significant improvement in WOMAC index (all its components and total value) and quality of life using EQ-5D in the first month of therapy and throughout the follow-up. Analysis based on the OMERACT-OARSI criteria indicated high treatment response rates in 92.5% of the patients at the end of therapy and in 92.2% three months after its completion. The body mass index and levels of low-density lipoproteins, triglycerides, glucose, and uric acid significantly decreased during treatment. Adverse events were detected in a small number (5.5%) of cases.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>остеоартрит</kwd><kwd>метаболический синдром</kwd><kwd>лечение</kwd><kwd>диацереин</kwd></kwd-group><kwd-group xml:lang="en"><kwd>osteoarthritis</kwd><kwd>metabolic syndrome</kwd><kwd>treatment</kwd><kwd>diacerein</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Allen KD, Choong PF, Davis AM, et al. OA: Models for appropriate care across the disease continuum. Best Pract Res Clin Rheumatol.2016 Jun;30(3):503-35. doi: 10.1016/j.berh.2016.09.003</mixed-citation><mixed-citation xml:lang="en">Allen KD, Choong PF, Davis AM, et al. OA: Models for appropriate care across the disease continuum. 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