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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">10.14412/1996-7012-2026-3-43-52</article-id><article-id custom-type="elpub" pub-id-type="custom">mrj-1996</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>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL INVESTIGATIONS</subject></subj-group></article-categories><title-group><article-title>Подходы к терапии метаболического фенотипа остеоартрита: эффективность комбинации глюкозамина и хондроитина сульфата, дополненной неденатурированным коллагеном 2-го типа, витаминами группы В, гингеролом и аскорбиновой кислотой</article-title><trans-title-group xml:lang="en"><trans-title>Approaches to therapy of the metabolic phenotype of osteoarthritis: efficacy of a combination of glucosamine and chondroitin sulfate supplemented with undenatured type 2 collagen, B vitamins, gingerol, and ascorbic acid</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8130-5081</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Стребкова</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Strebkova</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Екатерина Александровна Стребкова</p><p>115522, Москва, Каширское шоссе, 34А </p></bio><bio xml:lang="en"><p>Ekaterina Aleksandrovna Strebkova</p><p>34A, Kashirskoe Shosse, Moscow 115522 </p></bio><email xlink:type="simple">dr.ekaterinastrebkova@yandex.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/0000-0001-8218-3223</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Таскина</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Taskina</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А </p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522 </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/0000-0001-8732-2720</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кашеварова</surname><given-names>Н. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Kashevarova</surname><given-names>N. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А </p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522 </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/0000-0001-8562-6077</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Савушкина</surname><given-names>Н. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Savushkina</surname><given-names>N. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А </p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522 </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/0000-0003-4242-8278</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шарапова</surname><given-names>Е. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Sharapova</surname><given-names>E. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А </p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522 </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/0000-0003-0394-9249</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Короткова</surname><given-names>Т. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Korotkova</surname><given-names>T. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А </p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522 </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/0000-0002-0447-4110</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хальметова</surname><given-names>А. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Khalmetova</surname><given-names>A. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А </p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522 </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/0000-0002-1084-3920</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кудинский</surname><given-names>Д. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Kudinsky</surname><given-names>D. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А </p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522 </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/0000-0001-7017-0898</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>115522, Москва, Каширское шоссе, 34А </p><p>125993, Москва, ул. Баррикадная, 2/1, стр. 1 </p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522 </p><p>2/1, Barrikadnaya Street, Build. 1, Moscow 125993 </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/0000-0002-6068-3080</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, Москва, Каширское шоссе, 34А </p><p>125993, Москва, ул. Баррикадная, 2/1, стр. 1 </p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522 </p><p>2/1, Barrikadnaya Street, Build. 1, Moscow 125993 </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»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.A. Nasonova Research Institute of Rheumatology</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><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>24</day><month>06</month><year>2026</year></pub-date><volume>20</volume><issue>3</issue><fpage>43</fpage><lpage>52</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Стребкова Е.А., Таскина Е.А., Кашеварова Н.Г., Савушкина Н.М., Шарапова Е.П., Короткова Т.А., Хальметова А.Р., Кудинский Д.М., Алексеева Л.И., Лила А.М., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Стребкова Е.А., Таскина Е.А., Кашеварова Н.Г., Савушкина Н.М., Шарапова Е.П., Короткова Т.А., Хальметова А.Р., Кудинский Д.М., Алексеева Л.И., Лила А.М.</copyright-holder><copyright-holder xml:lang="en">Strebkova E.A., Taskina E.A., Kashevarova N.G., Savushkina N.M., Sharapova E.P., Korotkova T.A., Khalmetova A.R., Kudinsky D.M., Alekseeva L.I., Lila A.M.</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/1996">https://mrj.ima-press.net/mrj/article/view/1996</self-uri><abstract><p>Цель исследования – оценить эффективность фармаконутрицевтика Терафлекс Ультра, представляющего собой комбинацию глюкозамина (Г, 1500 мг), хондроитина сульфата (ХС, 1000 мг), неденатурированного коллагена 2-го типа (НК2, 40 мг), комплекса витаминов группы В, витамина С (100 мг) и экстракта корня имбиря (300 мг), у пациентов с метаболическим фенотипом ОА коленных суставов (КС).</p><sec><title>Материал и методы</title><p>Материал и методы. В проспективное рандомизированное исследование включено 29 женщин 40–75 лет с достоверным диагнозом ОА КС I–III стадии по Kellgren–Lawrence (установленным в соответствии с классификационными критериями ACR) и метаболическим синдромом, болью при ходьбе ≥40 мм по визуальной аналоговой шкале (ВАШ), подписавших информированное согласие. Средний возраст пациенток составил 62,4±6,9 года. Медиана боли по ВАШ исходно – 63 [54; 75] мм. Все пациентки в течение 6 мес получали фармаконутрицевтик Терафлекс Ультра перорально по 2 капсулы 2 раза в день; последующие 3 мес – период наблюдения и оценка эффекта последействия. Длительность исследования – 9 мес.</p></sec><sec><title>Результаты и обсуждение</title><p>Результаты и обсуждение. Результаты исследования продемонстрировали статистически значимый клинический эффект фармаконутрицевтика у пациенток с метаболическим ОА КС на протяжении 6-месячного курса терапии и в последующий период наблюдения. Через 1 мес лечения отмечалось значимое (р&lt;0,01) уменьшение боли при ходьбе в анализируемом КС по ВАШ, которое сохранялось в течение всего лечебного периода и через 3 мес после его завершения. Снижение боли до &lt;40 мм по ВАШ через 1 мес терапии достигнуто у 48,3% больных, через 3 мес – у 66,7%, а через 6 мес – у 81,5%. В период наблюдения у большинства пациенток (77,7%) уровень боли по ВАШ сохранялся на уровне &lt;40 мм. На фоне применения фармаконутрицевтика выявлено значимое улучшение всех параметров опросника WOMAC: уменьшение боли (исходно – 246 [159; 320] мм, через 1 мес – 173,5 [116; 199] мм, через 3 мес – 119 [70; 186] мм, через 6 мес – 84 [48; 157] мм, через 9 мес – 73 [42; 106] мм; р&lt;0,01 для всех показателей по сравнению с исходными данными); уменьшение скованности (исходно – 101 [63; 129] мм, через 1 мес – 69,5 [36,5; 90] мм, через 3 мес – 46 [23; 85] мм, через 6 мес – 36 [19; 74] мм, через 9 мес – 24 [15; 51] мм; р&lt;0,01 для всех показателей по сравнению с исходными данными); уменьшение функциональной недостаточности (исходно – 932 [610; 1085] мм, через 1 мес – 660,5 [459; 767] мм, через 3 мес – 463 [323; 748] мм, через 6 мес – 309 [211; 559] мм, через 9 мес – 265 [189; 440] мм; р&lt;0,01 для всех показателей по сравнению с исходными данными). У всех обследованных в течение 6 мес лечения и в период наблюдения определялось значимое улучшение показателей KOOS (р&lt;0,01), качества жизни по EQ 5D, оценки состояния здоровья пациентом по ВАШ (р&lt;0,01). В результате терапии большинство пациенток отказались от регулярного применения нестероидных противовоспалительных препаратов (НПВП).</p></sec><sec><title>Заключение</title><p>Заключение. У больных с метаболическим фенотипом ОА фармаконутрицевтик Терафекс Ультра (комбинация ХС, Г, НК2, витаминов группы В, витамина С и экстракта корня имбиря) продемонстрировал значимый клинический эффект, который сопровождался уменьшением боли, улучшением функции сустава и качества жизни, снижением потребности в НПВП.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title> Objective</title><p> Objective: to evaluate the efficacy of the nutraceutical Teraflex Ultra, a combination of glucosamine (G, 1500 mg), chondroitin sulfate (CS, 1000 mg), undenatured type 2 collagen (UC-2, 40 mg), a B-vitamin complex, vitamin C (100 mg), and ginger root extract (300 mg), in patients with the metabolic phenotype of knee osteoarthritis (OA).</p></sec><sec><title>Material and methods</title><p>Material and methods. This prospective randomized study included 29 women aged 40–75 years with a definite diagnosis of knee OA stage I–III according to Kellgren–Lawrence (established in accordance with the ACR classification criteria) and metabolic syndrome, pain on walking ≥40 mm on the visual analog scale (VAS), who provided informed consent. Mean age was 62.4±6.9 years. Median baseline VAS pain was 63 [54; 75] mm. All patients received the nutraceutical Teraflex Ultra orally, 2 capsules twice daily for 6 months; the subsequent 3 months constituted the follow-up period with assessment of the carryover effect. Study duration was 9 months.</p></sec><sec><title>Results and discussion</title><p>Results and discussion. The study results demonstrated a statistically significant clinical effect of the nutraceutical in patients with metabolic knee OA during the 6-month treatment course and the subsequent follow-up period. After 1 month of treatment, a significant (p&lt;0.01) reduction in pain on walking in the analyzed knee according to VAS was observed; it persisted throughout the treatment period and 3 months after completion. A reduction of pain to &lt;40 mm on VAS after 1 month of therapy was achieved in 48.3% of patients, after 3 months in 66.7%, and after 6 months in 81.5%. During follow-up, in most patients (77.7%) VAS pain remained &lt;40 mm. Treatment was associated with significant improvement in all WOMAC parameters: decreased pain (baseline 246 [159; 320] mm; 1 month 173.5 [116; 199] mm; 3 months 119 [70; 186] mm; 6 months 84 [48; 157] mm; 9 months 73 [42; 106] mm; p&lt;0.01 for all comparisons vs baseline); decreased stiffness (baseline 101 [63; 129] mm; 1 month 69.5 [36.5; 90] mm; 3 months 46 [23; 85] mm; 6 months 36 [19; 74] mm; 9 months 24 [15; 51] mm; p&lt;0.01 for all comparisons vs baseline); decreased functional limitation (baseline 932 [610; 1085] mm; 1 month 660.5 [459; 767] mm; 3 months 463 [323; 748] mm; 6 months 309 [211; 559] mm; 9 months 265 [189; 440] mm; p&lt;0.01 for all comparisons vs baseline). In all patients during the 6 months of treatment and the followup period, significant improvement in KOOS scores (p&lt;0.01), quality of life according to EQ-5D, and patient global health assessment by VAS (p&lt;0.01) was observed. As a result of therapy, most patients discontinued regular use of nonsteroidal anti-inflammatory drugs (NSAIDs). </p></sec><sec><title>Conclusion</title><p>Conclusion. In patients with the metabolic phenotype of OA, the nutraceutical Teraflex Ultra (a combination of CS, G, UC-2, B vitamins, vitamin C, and ginger root extract) demonstrated a significant clinical effect accompanied by reduced pain, improved joint function and quality of life, and decreased need for NSAIDs. </p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>остеоартрит</kwd><kwd>метаболический фенотип остеоартрита</kwd><kwd>хондроитина сульфат</kwd><kwd>глюкозамин</kwd><kwd>неденатурированный коллаген 2-го типа</kwd></kwd-group><kwd-group xml:lang="en"><kwd>osteoarthritis</kwd><kwd>metabolic phenotype of osteoarthritis</kwd><kwd>chondroitin sulfate</kwd><kwd>glucosamine</kwd><kwd>undenatured type 2 collagen</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Статья подготовлена в рамках научно-исследовательской работы (государственное задание № РК 125020501433-4).</funding-statement><funding-statement xml:lang="en">The article was prepared within the framework of the fundamental research project № RK 125020501433-4).</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">Sheng Z, Xie Y, Lyu L, et al. 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