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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">mrj</journal-id><journal-title-group><journal-title xml:lang="ru">Современная ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Modern Rheumatology Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1996-7012</issn><issn pub-type="epub">2310-158X</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/1996-7012-2021-6-117-123</article-id><article-id custom-type="elpub" pub-id-type="custom">mrj-1239</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>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Анализ терапевтических преимуществ медленнодействующих симптоматических средств при остеоартрите: акцент на структурно-модифицирующее действие</article-title><trans-title-group xml:lang="en"><trans-title>Analysis of the therapeutic benefits of symptomatic slow acting drugs in osteoarthritis: emphasis on structural-modifying action</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7981-6349</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Беляева</surname><given-names>И. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Belyaeva</surname><given-names>I. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>191015, Санкт-Петербург, ул. Кирочная, 41</p></bio><bio xml:lang="en"><p>41, Kirochnaya street, St. Petersburg 191015</p></bio><email xlink:type="simple">belib@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0797-2051</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мазуров</surname><given-names>В. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Mazurov</surname><given-names>V. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>191015, Санкт-Петербург, ул. Кирочная, 41</p></bio><bio xml:lang="en"><p>41, Kirochnaya street, St. Petersburg 191015</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3236-4485</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Трофимов</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Trofimov</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>191015, Санкт-Петербург, ул. Кирочная, 41</p></bio><bio xml:lang="en"><p>41, Kirochnaya street, St. Petersburg 191015</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова»&#13;
Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>North-Western State Medical University named after I.I. Mechnikov</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>16</day><month>12</month><year>2021</year></pub-date><volume>15</volume><issue>6</issue><fpage>117</fpage><lpage>123</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Беляева И.Б., Мазуров В.И., Трофимов Е.А., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Беляева И.Б., Мазуров В.И., Трофимов Е.А.</copyright-holder><copyright-holder xml:lang="en">Belyaeva I.B., Mazurov V.I., Trofimov E.A.</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://mrj.ima-press.net/mrj/article/view/1239">https://mrj.ima-press.net/mrj/article/view/1239</self-uri><abstract><p>В обзоре представлен анализ терапевтического действия при остеоартрите (ОА) оригинального комплексного инъекционного препарата Алфлутоп (биоактивного концентрата мелких морских рыб), являющегося одним из наиболее широко используемых симптоматических препаратов замедленного действия (SYSADOA) в России. Он стимулирует пролиферацию хондроцитов, активирует синтез внеклеточного матрикса посредством модуляции трансформирующего фактора роста β (ТФРβ), ингибирует гиалуронидазу, окислительный стресс и активность внеклеточной экспрессии генов провоспалительных цитокинов – интерлейкина (ИЛ) 1β, ИЛ6 и ИЛ8 in vitro.</p><p>Приведены результаты проспективных клинических исследований, которые демонстрируют способность Алфлутопа замедлять рентгенологическое прогрессирование ОА коленных суставов (тормозить сужение суставной щели, рост остеофитов и повышать внутрисуставную концентрацию гиалуроновой кислоты), а также восстанавливать подвижность тазобедренных суставов при его локальном введении в зону патологических изменений суставной губы вертлужной впадины. Комбинированная терапия с применением Алфлутопа приводит к активации репаративных процессов и значимому клиническому улучшению у пациентов с посттравматическим ОА, а также замедляет прогрессирование хондродегенерации по данным магнитно-резонансной томографии. Новый режим введения Алфлутопа при ОА коленного сустава (по 2 мл через день, №10) может повышать приверженность пациентов терапии.</p><p>Представленные в обзоре результаты клинических исследований доказывают структурно-модифицирующее действие Алфлутопа при ОА различной локализации и обосновывают его широкое использование при данном заболевании в ревматологической, травматологической и ортопедической практике. </p></abstract><trans-abstract xml:lang="en"><p>The review presents an analysis of the therapeutic effect in osteoarthritis (OA) of the original complex injectable drug Alflutop (bioactive concentrate of small marine fish), which is one of the most widely used symptomatic slow acting drugs (SYSADOA) in Russia. It stimulates the proliferation of chondrocytes, activates the synthesis of the extracellular matrix by modulating transforming growth factor β (TGFβ), inhibits hyaluronidase, oxidative stress and the activity of extracellular expression of proinflammatory cytokine genes – interleukin (IL) 1β, IL6 and IL8 in vitro.</p><p>The results of prospective clinical studies are presented, which demonstrate the ability of Alflutop to slow down the X-ray progression of OA of the knee joints (inhibit the narrowing of the joint space, the growth of osteophytes and increase the intra-articular concentration of hyaluronic acid), as well as restore the mobility of the hip joints when it is locally introduced into the zone of pathological changes in the articular lip of the acetabulum. Combined therapy with Alflutop leads to activation of reparative processes and significant clinical improvement in patients with post-traumatic OA, and also slows down the progression of chondrodegeneration according to magnetic resonance imaging. The new Alflutop administration regimen for knee OA (2 ml every other day, №10) can increase patient adherence to therapy.</p><p>The results of clinical studies presented in the review prove the structural-modifying effect of Alflutop in OA of various localization and substantiate its widespread use in this disease in rheumatological, traumatological and orthopedic practice.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>Алфлутоп</kwd><kwd>биоактивный концентрат рыб</kwd><kwd>остеоартрит</kwd><kwd>структурно-модифицирующее действие</kwd><kwd>SYSADOA</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Alflutop</kwd><kwd>bioactive fish concentrate</kwd><kwd>osteoarthritis</kwd><kwd>structural and modifying action</kwd><kwd>SYSADOA</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">Лила АМ, Трофимова АС, Трофимов ЕА. Остеоартрит. 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