Перспективы применения новых антидиабетических препаратов в ревматологии

В спектре коморбидной патологии при ревматических и мышечно-скелетных заболеваниях (РМЗ) особое внимание привлекают метаболические нарушения, в первую очередь ожирение, ассоциирующееся с увеличением в популяции риска развития аутоиммунных заболеваний, в том числе РМЗ. В ревматологии проблема применения антидиабетических препаратов, снижающих риск развития ожирения, рассматривается не только с точки зрения лечения сахарного диабета 2-го типа, но и как более широкая проблема, связанная с перспективами репозиционирования как стратегии поиска новых медицинских показаний для уже существующих, разрешенных к применению или исследованных препаратов, что особенно актуально для гармонизации терапии комплексных РМЗ. В последние годы для лечения сахарного диабета 2-го типа и его осложнений разработаны новые классы препаратов – агонисты рецепторов глюкагоноподобного пептида 1-го типа (арГПП-1) и ингибиторы натрий-глюкозного котранспортера 2 (иНГЛТ-2; глифлозины).

Наряду с классическими антидиабетическими эффектами, арГПП-1 и иНГЛТ-2 обладают широким спектром антивоспалительных и иммуномодулирующих механизмов действия, которые могут потенциировать эффективность противоспалительной терапии РМЗ и сдерживать развитие коморбидной патологии. В статье обсуждаются данные, касающиеся механизмов антивоспалительной активности антидиабетических препаратов и их эффективности при РМЗ. Для того чтобы определить истинное место этих препаратов в отношении персонификации терапии РМЗ, в первую очередь снижения риска различных коморбидной патологии, необходимы дальнейшие исследования, направленные на прямое сравнение эффективности препаратов при различных клинических сценариях.

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