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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">10.14412/1996-7012-2023-4-115-119</article-id><article-id custom-type="elpub" pub-id-type="custom">mrj-1448</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>СОВЕТ ЭКСПЕРТОВ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>EXPERT ADVICE</subject></subj-group></article-categories><title-group><article-title>Резолюция Совета экспертов от 20 мая 2023 г. «Вопросы безопасности лечения ревматологического пациента»</article-title><trans-title-group xml:lang="en"><trans-title>Resolution of the Council of Experts of May 20, 2023 "Issues of safety in the treatment of a rheumatological patient"</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7017-0898</contrib-id><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>Кафедра ревматологии ФГБОУ ДПО «РМАНПО» Минздрава России.</p><p>115522, Москва, Каширское шоссе, 34А; 125993, Москва, ул. Баррикадная, 2/1, стр.1</p></bio><bio xml:lang="en"><p>Department of Rheumatology Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia, Moscow;</p><p>34A, Kashirskoe Shosse, Moscow 115522; 2/1, Barrikadnaya Street, Build. 1, Moscow 125993</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>Аношенкова</surname><given-names>О. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Anoshenkova</surname><given-names>O. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>634050, Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>2, Moskovsky Trakt, Tomsk 634050</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>Долганова</surname><given-names>Н. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Dolganova</surname><given-names>N. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>649002, Горно-Алтайск, Коммунистический проспект, 130</p></bio><bio xml:lang="en"><p>130, Kommunistichesky Prospect, Gorno-Altaysk 649002</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2835-2839</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жолобова</surname><given-names>Е. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Zholobova</surname><given-names>E. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119991, Москва, ул. Трубецкая, 8, стр. 2; 119049, Москва, 4-й Добрынинский переулок, 1/9</p></bio><bio xml:lang="en"><p>8, Trubetskaya Street, Build. 2, Moscow 119991; 1/9, 4th Dobryninsky Lane, Moscow 119049</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8529-4105</contrib-id><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>Зонова Елена Владимировна.</p><p>630091, Новосибирск, Красный проспект, 52</p></bio><bio xml:lang="en"><p>Elena V. Zonova.</p><p>52, Krasny Prospect, Novosibirsk 630091</p></bio><email xlink:type="simple">elena_zonova@list.ru</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5474-8565</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лапшина</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Lapshina</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>420012, Казань, ул. Бутлерова, 49</p></bio><bio xml:lang="en"><p>49, Butlerov Street, Kazan 420012</p></bio><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4890-0847</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Королев</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Korolev</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>630090, Новосибирск, Проспект академика Лаврентьева, 10</p></bio><bio xml:lang="en"><p>10, Akademik Lavrentyev Prospect, Novosibirsk 630090</p></bio><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1525-2003</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Меньшикова</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Menshikova</surname><given-names>L. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>664049, Иркутск, микрорайон Юбилейный, 100</p></bio><bio xml:lang="en"><p>100, Yubileyny Microdistrict, Irkutsk 664049</p></bio><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8652-1410</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шестерня</surname><given-names>П. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shesternya</surname><given-names>P. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>660022, Красноярск, ул. Партизана Железняка, 1</p></bio><bio xml:lang="en"><p>1, Partizana Zheleznyaka Street, Krasnoyarsk 660022</p></bio><xref ref-type="aff" rid="aff-9"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6408-0965</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Часовских</surname><given-names>Ю. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Chasovskikh</surname><given-names>Yu. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>634050, Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>2, Moskovsky Trakt, Tomsk 634050</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Siberian 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>БУЗ Республики Алтай «Республиканская больница»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Republican Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский университет); Центр детской ревматологии на базе ГБУЗ «Морозовская детская клиническая больница Департамента здравоохранения г. Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Center for Pediatric Rheumatology, Morozov Children's Clinical Hospital of the Moscow Health Department</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><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-6"><aff xml:lang="ru"><institution>ФГБОУ ВО «Казанский медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kazan State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru"><institution>ФГБНУ «ФИЦ Институт цитологии и генетики СО РАН»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal Research Center Institute of Cytology and Genetics</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru"><institution>Иркутская государственная медицинская академия последипломного образования — филиал ФГБОУДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Irkutsk State Medical Academy of Postgraduate Education, brunch of Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-9"><aff xml:lang="ru"><institution>ГБОУ ВО «Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>18</day><month>08</month><year>2023</year></pub-date><volume>17</volume><issue>4</issue><fpage>115</fpage><lpage>119</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Алексеева Л.И., Аношенкова О.Н., Долганова Н.Г., Жолобова Е.С., Зонова Е.В., Лапшина С.А., Королев М.А., Меньшикова Л.В., Шестерня П.А., Часовских Ю.П., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Алексеева Л.И., Аношенкова О.Н., Долганова Н.Г., Жолобова Е.С., Зонова Е.В., Лапшина С.А., Королев М.А., Меньшикова Л.В., Шестерня П.А., Часовских Ю.П.</copyright-holder><copyright-holder xml:lang="en">Alekseeva L.I., Anoshenkova O.N., Dolganova N.G., Zholobova E.S., Zonova E.V., Lapshina S.A., Korolev M.A., Menshikova L.V., Shesternya P.A., Chasovskikh Y.P.</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/1448">https://mrj.ima-press.net/mrj/article/view/1448</self-uri><abstract><p>На заседании Совета экспертов 20 мая 2023 г. были рассмотрены вопросы безопасности лечения пациентов с остеоартритом (ОА) — самой распространенной формой заболеваний суставов. Первым шагом терапии ОА должно быть назначение симптоматических средств замедленного действия (SYSADOA) и нестероидных противовоспалительных препаратов (НПВП). Однако, учитывая современные представления о патогенезе воспаления, а также то, что это активный процесс с участием большого числа провоспалительных и проразрешающих медиаторов, представляется актуальной тактика ограничения терапии с подавлением циклооксигеназы 2 и включения в схемы лечения лекарственных средств с многоцелевым действием, способствующих разрешению воспаления, в частности препаратов Цель® Т и Траумель® С. Траумель® С оказывает воздействие на все этапы воспаления, в большей степени на синтез проразрешающих медиаторов, а Цель® Т влияет на хондрогенез, воспаление, метаболические процессы в хрящевой ткани и предотвращает ангиогенез.</p><p>Отмечено, что при невозможности назначения системных НПВП для купирования боли целесообразно применение препарата Траумель® С. Сочетание доказанной терапевтической эффективности препаратов Цель® Т и Траумель® С с минимальным числом нежелательных явлений и отсутствием взаимодействий с другими лекарственными средствами позволяет использовать их как самостоятельную схему терапии при ОА.</p></abstract><trans-abstract xml:lang="en"><p>At the meeting of the Expert Council on May 20, the safety of treatment for patients with osteoarthritis (OA), the most common form of joint disease, was discussed. The first step in the treatment of OA should be the administration of symptomatic delayed-acting agents (SYSADOA) and nonsteroidal anti-inflammatory drugs (NSAIDs). However, given the current understanding of the pathogenesis of inflammation, as well as the fact that it is an active process involving multiple proinflammatory and pro-resolving mediators, it is reasonable to limit the cyclooxygenase-2 suppressive treatment and to include medications with multipurpose effects that contribute to the resolution of inflammation, in particular Zeel® T and Traumeel® S. Traumeel® S affects all stages of inflammation, mostly on the pro-resolving mediators synthesis, and Zeel® T affects chondrogenesis, inflammation, metabolic processes in cartilage tissue and prevents angiogenesis.</p><p>It was found that it is advisable to use Traumeel® S when it is not possible to prescribe systemic NSAIDs for pain relief. The combination of the proven therapeutic efficacy of Zeel® T and Traumeel® S with a minimal number of adverse events and the absence of interactions with other drugs allows them to be used as an independent treatment regimen for OA.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>остеоартрит</kwd><kwd>лечение</kwd><kwd>лекарственные средства с многоцелевым действием</kwd></kwd-group><kwd-group xml:lang="en"><kwd>osteoarthritis</kwd><kwd>treatment</kwd><kwd>drugs with multipurpose action</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Статья спонсируется ООО «Хеель Рус».</funding-statement><funding-statement xml:lang="en">The article is sponsored by Heel.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">https://www.who.int/ru/news-room/fact-sheets/detail/musculoskeletal-conditions</mixed-citation><mixed-citation xml:lang="en">https://www.who.int/ru/news-room/fact-sheets/detail/musculoskeletal-conditions</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Зоткин ЕГ, Дыдыкина ИС, Лила АМ. 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