rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2022-205-213rsp-3154Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESПерспективы противовоспалительной и уратснижающей терапии подагры: вектор от прошлого к будущемуProspects of anti-inflammatory and urate-lowering therapy of gout: A vector from the past to the futurehttps://orcid.org/0000-0001-6665-1533ГаранинА. А.GaraninA. A.

Гаранин Андрей Александрович

443099, Самара, ул. Чапаевская, 89

Andrey A. Garanin

443099, Samara, Chapaevskaya str., 89

sameagle@yandex.ruhttps://orcid.org/0000-0002-0077-7982НовичковаН. Л.NovichkovaN. L.

443099, Самара, ул. Чапаевская, 89

Nadezhda L. Novichkova

443099, Samara, Chapaevskaya str., 89

https://orcid.org/0000-0003-3501-2354ЛебедевП. А.NovichkovaN. L.

443099, Самара, ул. Чапаевская, 89

Petr A. Lebedev

443099, Samara, Chapaevskaya str., 89

ФГБОУ ВО Самарский государственный медицинский университет Минздрава РоссииРоссияSamara State Medical UniversityRussian Federation202214052022602205213Copyright © Гаранин А.А., Новичкова Н.Л., Лебедев П.А., 20222022Гаранин А.А., Новичкова Н.Л., Лебедев П.А.Garanin A.A., Novichkova N.L., Novichkova N.L.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3154

В статье приводится обзор новых и перспективных препаратов для противоспалительной и уратснижающей терапии подагры – как уже зарегистрированных и применяющихся в клинической практике, так и находящихся на этапах внедрения или клинического исследования и демонстрирующих свою высокую эффективность и безопасность. Показаны современные подходы к терапии подагры, получившие свое отражение в зарубежных и отечественных клинических рекомендациях. Акцент сделан на безопасности и эффективности колхицина при подагрическом артрите и его кардиопротективных свойствах у пациентов, страдающих подагрой в сочетании с сердечно-сосудистой патологией. Приводятся сведения об эффективности нового противовоспалительного средства для симптоматической терапии подагры – канакинумаба, по опыту применения которого наша страна занимает лидерские позиции в Европе. Эффективность и безопасность анакинры позволяет рассматривать ее как перспективную альтернативу традиционному подходу к противовоспалительной терапии подагры. Рилонацепт позволяет врачам сформировать больше потенциальных алгоритмов лечения в популяции пациентов с подагрой, трудно поддающейся традиционной терапии. Приведены исторические сведения о применении адренокортикотропного гормона в качестве противовоспалительного агента при подагре. Представлена информация о резервных, новых и перспективных уратснижающих препаратах. Фокус сделан на безопасности и эффективности фебуксостата, подтвержденных результатами последних крупных рандомизированных клинических исследований. Рассмотрены другие препараты, снижающие уровень мочевой кислоты в плазме крови: урикозурические средства (пробенецид, бензбромарон, сульфинпиразон, лезинурад, веринурад, дотинурад и архалофенат), ингибиторы ксантиноксидазы (аллопуринол и топироксостат), препараты пегилированной уриказы (пеглотиказа и расбуриказа), которые можно рассматривать в будущем как препараты резерва с возможностью сочетанного применения с основными средствами для уратснижающей терапии.

The article provides an overview of new and promising drugs aimed at anti-inflammatory and urate-lowering therapy of gout, both already registered and used in clinical practice, and at the stages of implementation or clinical research and demonstrating their high efficacy and safety. Modern views and approaches to the treatment of gout, reflected in foreign and domestic clinical recommendations, are shown. Emphasis is placed on the safety and efficacy of colchicine in gouty arthritis and its cardioprotective properties in comorbid patients suffering from gout in combination with cardiovascular pathology. Information is provided on the effectiveness of new anti-inflammatory drugs for symptomatic therapy of gout: kanakinumab, according to the experience of which our country occupies a leading position in Europe. The efficacy and safety of anakinra allows us to consider the drug as an effective alternative to the traditional approach to antiinflammatory therapy of gout. Rilonacept provides doctors with more potential treatment algorithms in a population of patients with gout that is difficult to treat with traditional treatment. The historical data on the use of adrenocorticotropic hormone as an anti-inflammatory agent in gout are given. Information on reserve, new and promising urate-lowering drugs is provided. The focus is on the safety and efficacy of febuxostat, based on the results of recent large randomized clinical trials. Other drugs that reduce the level of uric acid in the blood plasma are considered: uricosuric agents (probenecid, benzbromarone, sulfinpyrazone, lezinurad, verinurad, dotinurad and archalophenate), xanthine oxidase inhibitors (allopurinol and topiroxostat), pegylated uricase preparations (pegloticase and rasburicase), which can be considered in the future as reserve drugs with the possibility of combined applications with the main means for urate-lowering therapy.

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