rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2021-129-133rsp-3014Research ArticleМЕЖДУНАРОДНЫЕ И РОССИЙСКИЕ РЕКОМЕНДАЦИИ ПО ЛЕЧЕНИЮ РЕВМАТИЧЕСКИХ ЗАБОЛЕВАНИЙINTERNATIONAL AND RUSSIAN GUIDELINES FOR THE TREATMENT OF RHEUMATIC DISEASESРекомендации Американской коллегии ревматологов (2020 г.) по ведению больных подагрой: что нового и что спорноACR management guidelines for the treatment of gout: What’s new and what’s controversialhttps://orcid.org/0000-0003-1191-5831ЕлисеевМ. С.EliseevM. S.

Елисеев Максим Сергеевич

115522, Москва, Каширское шоссе, 34а

Maksim S. Eliseev

115522, Moscow, Kashirskoye Highway, 34A

elicmax@rambler.ruФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202110052021592129133Copyright © Елисеев М.С., 20212021Елисеев М.С.Eliseev M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3014

Сосуществование множества национальных и международных рекомендаций, посвященных лечению конкретного заболевания, в том числе подагры, полностью оправдано, так как позволяет учитывать региональные и этнические особенности проявлений болезни, что может быть важным при подборе терапии. Однако нередко это сопряжено с диссонансом в отношении решения ключевых вопросов, стоящих перед практическим врачом. Публикация в 2020 г. обновленных рекомендаций Американской коллегии ревматологов (American College of Rheumatology, ACR) по ведению больных подагрой выявила разногласия как с некоторыми постулатами предыдущей версии, так и с другими подобными работами, например, с опубликованными в том же году рекомендациями Французской ассоциации ревматологов. Среди спорных положений новой версии рекомендаций ACR – унифицированный для всех пациентов целевой уровень мочевой кислоты, показания к проведению лекарственной терапии, выбор препарата у пациентов со сниженной функцией почек, профилактика приступов артрита при начале уратснижающей терапии. В статье обсуждены эти и другие спорные вопросы терапии подагры на основании анализа последних рекомендаций ACR.

The community of many national and international recommendations dedicated to the treatment of a specific disease, including gout, is fully justified, since it allows taking into account, for example, regional, ethnic characteristics of the manifestations of the disease, which can be important when choosing a therapy. However, this is often associated with dissonance regarding the solution of key issues facing the practitioner. The publication in 2020 of the updated American College of Rheumatology (ACR) guidelines for the management of gout revealed controversy with some of the previous version’s postulates, as well as with other similar work, for example, with the guidelines published in the same year and the French Association of Rheumatology. Among the controversial provisions of the new version of the ACR recommendations are the unified target level of uric acid for all patients, indications for drug therapy, the choice of a drug in patients with reduced renal function, prevention of arthritis attacks when starting uratelowering therapy. This article discusses these and other controversial issues in gout therapy based on an analysis of the latest ACR guidelines.

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The authors declare that there are no conflicts of interest present.