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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">10.14412/1996-7012-2023-5-123-131</article-id><article-id custom-type="elpub" pub-id-type="custom">mrj-1488</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>Мультиморбидность при остеоартрите и плейотропные эффекты симптоматических средств замедленного действия. Резолюция международного мультидисциплинарного совета экспертов</article-title><trans-title-group xml:lang="en"><trans-title>Multimorbidity in osteoarthritis and pleiotropic effects of slow-acting symptomatic drugs. Resolution of the multidisciplinary International Expert Council</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0797-2051</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</p><p>Кирочная ул., 41</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>191015</p><p>41, Kirochnaya Street</p><p>St. Petersburg</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/0000-0002-6068-3080</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лила</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Lila</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522</p><p>Каширское шоссе, 34А</p><p>кафедра ревматологии</p><p>125993</p><p>ул. Баррикадная, 2/1, стр. 1</p><p>Москва</p></bio><bio xml:lang="en"><p>115522</p><p>34A, Kashirskoe Shosse</p><p>Department of Rheumatology</p><p>125993</p><p>2/1, Barrikadnaya Street, Build. 1</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><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>Людмила Ивановна Алексеева</p><p>115522</p><p>Каширское шоссе, 34А</p><p>кафедра ревматологии</p><p>125993</p><p>ул. Баррикадная, 2/1, стр. 1</p><p>Москва</p></bio><bio xml:lang="en"><p>Lyudmila Ivanovna Alekseeva</p><p>115522</p><p>34A, Kashirskoe Shosse</p><p>Department of Rheumatology</p><p>125993</p><p>2/1, Barrikadnaya Street, Build. 1</p><p>Moscow</p></bio><email xlink:type="simple">dr.alekseeva@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Баймухамедов</surname><given-names>Ч. Т.</given-names></name><name name-style="western" xml:lang="en"><surname>Baymukhamedov</surname><given-names>Ch. T.</given-names></name></name-alternatives><bio xml:lang="ru"><p>160013</p><p>ул. Сасбукаева, 32А</p><p>Шымкент</p></bio><bio xml:lang="en"><p>160013</p><p>32A, Sasbukaeva Street</p><p>Shymkent</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Исаева</surname><given-names>Б. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Isaeva</surname><given-names>B. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>050012</p><p>ул. Толе Би, 94</p><p>Алматы</p></bio><bio xml:lang="en"><p>050012</p><p>94, Tole Bi Street</p><p>Almaty</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/0000-0003-4947-4779</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Искра</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Iskra</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>194044</p><p>ул. Академика Лебедева, 6</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>194044</p><p>6, Academik Lebedev Street</p><p>St. Petersburg</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2584-8783</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Каримов</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Karimov</surname><given-names>M. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>100109</p><p>ул. Фараби, 2</p><p>Ташкент</p></bio><bio xml:lang="en"><p>100109</p><p>2, Farabi Street</p><p>Tashkent</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/0000-0003-1025-8825</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мирахмедова</surname><given-names>Х. Т.</given-names></name><name name-style="western" xml:lang="en"><surname>Mirakhmedova</surname><given-names>H. T.</given-names></name></name-alternatives><bio xml:lang="ru"><p>100109</p><p>ул. Фараби, 2</p><p>Ташкент</p></bio><bio xml:lang="en"><p>100109</p><p>2, Farabi Street</p><p>Tashkent</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/0000-0003-1316-5245</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мкртумян</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Mkrtumyan</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>127006</p><p>Долгоруковская ул., 4</p><p>Москва</p></bio><bio xml:lang="en"><p>127006</p><p>4, Dolgorukovskaya Street</p><p>Moscow</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/0000-0002-7879-1522</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Набиева</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Nabieva</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>100109</p><p>ул. Фараби, 2</p><p>Ташкент</p></bio><bio xml:lang="en"><p>100109</p><p>2, Farabi Street</p><p>Tashkent</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/0000-0002-6253-621X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Наумов</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Naumov</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>129226</p><p>1-я Леонова ул., 16</p><p>Москва</p></bio><bio xml:lang="en"><p>129226</p><p>16, 1st Leonova Street</p><p>Moscow</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/0000-0002-4193-688X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ткачева</surname><given-names>О. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Tkacheva</surname><given-names>O. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>129226</p><p>1-я Леонова ул., 16</p><p>Москва</p></bio><bio xml:lang="en"><p>129226</p><p>16, 1st Leonova Street</p><p>Moscow</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/0000-0003-3236-4485</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</p><p>Кирочная ул., 41</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>191015</p><p>41, Kirochnaya Street</p><p>St. Petersburg</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>Хохлова</surname><given-names>М. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Khokhlova</surname><given-names>M. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>105120</p><p>ул. Земляной Вал, 53</p><p>Москва</p></bio><bio xml:lang="en"><p>105120</p><p>53, Zemlyanoy Val Street</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-9"/></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, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><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-3"><aff xml:lang="ru"><institution>Центр болезней суставов</institution><country>Казахстан</country></aff><aff xml:lang="en"><institution>Center of Joint Diseases</institution><country>Kazakhstan</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>НАО «Казахский национальный медицинский университет им. С.Д. Асфендиярова»</institution><country>Казахстан</country></aff><aff xml:lang="en"><institution>Asfendiyarov Kazakh National Medical University</institution><country>Kazakhstan</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Military Medical Academy named after S.M. Kirov, Ministry of Defense of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>Ташкентская медицинская академия</institution><country>Узбекистан</country></aff><aff xml:lang="en"><institution>Tashkent Medical Academy</institution><country>Uzbekistan</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru"><institution>ФГБОУ ВО «Московский государственный медико-&#13;
стоматологический университет»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow State Medical Dentistry University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru"><institution>Российский геронтологический научно-клинический центр ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Gerontological Research Clinical Center, Pirogov Russian National Research Medical University, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-9"><aff xml:lang="ru"><institution>ГАУЗ «Московский научно-практический центр медицинской реабилитации, восстановительной и спортивной медицины Департамента здравоохранения Москвы», филиал № 1 Клиника спортивной медицины</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow Centre foe Research and Practice in&#13;
Medical Rehabilitation, Restorative and Sports Medicine, Moscow Healthcare Department</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>10</month><year>2023</year></pub-date><volume>17</volume><issue>5</issue><fpage>123</fpage><lpage>131</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Мазуров В.И., Лила А.М., Алексеева Л.И., Баймухамедов Ч.Т., Исаева Б.Г., Искра Д.А., Каримов М.Ю., Мирахмедова Х.Т., Мкртумян А.М., Набиева Д.А., Наумов А.В., Ткачева О.Н., Трофимов Е.А., Хохлова М.Н., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Мазуров В.И., Лила А.М., Алексеева Л.И., Баймухамедов Ч.Т., Исаева Б.Г., Искра Д.А., Каримов М.Ю., Мирахмедова Х.Т., Мкртумян А.М., Набиева Д.А., Наумов А.В., Ткачева О.Н., Трофимов Е.А., Хохлова М.Н.</copyright-holder><copyright-holder xml:lang="en">Mazurov V.I., Lila A.M., Alekseeva L.I., Baymukhamedov C.T., Isaeva B.G., Iskra D.A., Karimov M.Y., Mirakhmedova H.T., Mkrtumyan A.M., Nabieva D.A., Naumov A.V., Tkacheva O.N., Trofimov E.A., Khokhlova M.N.</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/1488">https://mrj.ima-press.net/mrj/article/view/1488</self-uri><abstract><p>   В последние десятилетия во всем мире наблюдается увеличение распространенности остеоартрита (ОА) – одного из самых инвалидизирующих заболеваний, являющегося значительным бременем для общества. В рамках международного мультидисциплинарного совещания эксперты разных специальностей (ревматологи, неврологи, эндокринологи, гериатры, реабилитологи, травматологи-ортопеды) из России, Узбекистана и Казахстана указали на важность индивидуализированного подхода к пациентам с ОА с учетом коморбидных заболеваний, выделили наиболее актуальные и распространенные клинические фенотипы ОА, обсудили хорошо известные симптом- и структурно-модифицирующие эффекты комбинации глюкозамина и хондроитина сульфата, а также новые данные о дополнительных (плейотропных) свойствах этих препаратов, которые могут оказывать благоприятное влияние на течение коморбидных заболеваний. В резолюции совета экспертов суммированы результаты обсуждений и выделены вопросы, важные для дальнейшей разработки терапевтических подходов и рекомендаций по ведению таких пациентов.</p></abstract><trans-abstract xml:lang="en"><p>   In recent decades, the prevalence of osteoarthritis (OA), one of the most disabling diseases, has increased worldwide, which imposes a significant burden on society. At the international multidisciplinary meeting, experts of various specialties (rheumatology, neurology, endocrinology, geriatrics, rehabilitation, traumatology and orthopedics) from Russia, Uzbekistan, and Kazakhstan discussed the importance of an individualized approach to the treatment of patients with OA, taking into account comorbidities, identified the most important and common clinical phenotypes of the disease, discussed known symptom- and structure-modifying effects of a combination of glucosamine and chondroitin sulfate, and new data on additional (pleiotropic) effects of these drugs that may have a positive impact on the course of comorbid diseases and conditions. The resolution of the Expert Council summarizes the results of the discussion and focuses on issues that are important for the further development of therapeutic approaches and recommendations for the management of such patients.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>остеоартрит</kwd><kwd>мультиморбидность</kwd><kwd>плейотропные эффекты</kwd><kwd>глюкозамин</kwd><kwd>хондроитина сульфат</kwd><kwd>фенотип</kwd><kwd>Терафлекс</kwd></kwd-group><kwd-group xml:lang="en"><kwd>osteoarthritis</kwd><kwd>multimorbidity</kwd><kwd>pleiotropic effects</kwd><kwd>glucosamine</kwd><kwd>chondroitin sulfate</kwd><kwd>phenotype</kwd><kwd>Theraflex</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Совет экспертов организован при поддержке компании «Байер»</funding-statement><funding-statement xml:lang="en">The Expert Council was organized with the support of Bayer</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">Hunter DJ, March L, Chew M. 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