farmaecFARMAKOEKONOMIKA. Modern Pharmacoeconomics and PharmacoepidemiologyФАРМАКОЭКОНОМИКА. Современная фармакоэкономика и фармакоэпидемиология2070-49092070-4933IRBIS LLC10.17749/2070-4909/farmakoekonomika.2023.207farmaec-874Research ArticleREVIEW ARTICLESОБЗОРНЫЕ ПУБЛИКАЦИИDisease-modifying osteoarthritis drugs (DMOADs): new trends in osteoarthritis therapyБолезнь-модифицирующие остеоартрит препараты (DMOADs) – новые тенденции в терапии пациентов с остеоартритомhttps://orcid.org/0000-0003-3726-0730ШавловскаяО. А.ShavlovskayaO. A.

д.м.н., профессор кафедры организации медицинской реабилитации и санаторно-курортного лечения АНО ВО «Международный университет восстановительной медицины»

Фурманный пер., д. 8, стр. 2, Москва 105062

Dr. Med. Sc., Professor, Chair of Organization of Medical Rehabilitation and Sanatorium Treatment, International University of Restorative Medicine

8 bldg 2 Furmannyy Passage, Moscow 105062

shavlovskaya@1msmu.ruhttps://orcid.org/0000-0002-7663-710XГромоваО. А.GromovaО. А.

д.м.н., ведущий научный сотрудник ФИЦ «Информатика и управление» РАН

ул. Вавилова, д. 44, корп. 2, Москва 211933

Dr. Med. Sc., Professor, Leading Researcher, Federal Research Center “Computer Science and Control”, RAS

44 corp. 2 Vavilov Str., Moscow 211933

https://orcid.org/0000-0002-2466-7120КочишА. Ю.KochishA. Yu.

д.м.н., профессор, заместитель директора ФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии им. Р.Р. Вредена» Минздрава России

ул. Академика Байкова, д. 8, Санкт-Петербург 195427

Dr. Med. Sc., Professor, Deputy Director, Vreden National Medical Research Center of Traumatology and Orthopedics

8 Academician Baykov Str., Saint Petersburg 195427

https://orcid.org/0000-0002-0928-2054ЮхновскаяЮ. Д.YukhnovskayaYu. D.

клинический ординатор кафедры клинической иммунологии и аллергологии ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России

ул. Трубецкая, д. 8, стр. 2, Москва 119991

Clinical Resident, Chair of Clinical Immunology and Allergology, Sechenov University

18 bldg 2 Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0002-0756-7961РомановИ. Д.RomanovI. D.

врач-невролог, руководитель по научной и консультативной неврологической помощи ООО «МД Клиник»

ул. Дмитриевского, д. 11, Москва 111675

Neurologist, Head of Scientific and Advisory Neurological Care, “MD Clinic” LLC

11 Dmitrievskiy Str., Moscow 111674

https://orcid.org/0000-0002-1640-1605БоковаИ. А.BokovaI. A.

к.м.н., доцент кафедры восстановительной медицины, реабилитации и курортологии ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский университет)

ул. Трубецкая, д. 8, стр. 2, Москва 119991

MD, PhD, Associate Professor, Chair of Restorative Medicine, Rehabilitation and Balneology, Sechenov Univer

18 bldg 2 Trubetskaya Str., Moscow 119991

Автономная некоммерческая организация высшего образования «Международный университет восстановительной медицины»РоссияInternational University of Restorative MedicineRussian FederationФедеральный исследовательский центр «Информатика и управление» Российской академии наукРоссияFederal Research Center “Computer Science and Control”, Russian Academy of SciencesRussian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр травматологии и ортопедии им. Р.Р. Вредена» Министерства здравоохранения Российской ФедерацииРоссияVreden Russian Scientific Research Institute of Traumatology and OrthopedicsRussian FederationФедеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет им. И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский университет)РоссияSechenov UniversityRussian FederationОбщество с ограниченной ответственностью «МД-Клиник»РоссияMD Clinic LLCRussian Federation202310102023163482499Copyright © Shavlovskaya O.A., Gromova О.А., Kochish A.Y., Yukhnovskaya Y.D., Romanov I.D., Bokova I.A., 20232023Шавловская О.А., Громова О.А., Кочиш А.Ю., Юхновская Ю.Д., Романов И.Д., Бокова И.А.Shavlovskaya O.A., Gromova О.А., Kochish A.Y., Yukhnovskaya Y.D., Romanov I.D., Bokova I.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pharmacoeconomics.ru/jour/article/view/874

The review examines pharmacological agents that can have potential disease-modifying osteoarthritis drugs (DMOADs) status. DMOADs prevent the progression and further structural joint damage (structure-modifying effect), leading to a decrease in symptoms severity (symptom-modifying effect), such as pain, and improvement of joint function. Approaches to potential DMOADs selection are discussed: (1) the preferred target (bone, cartilage, synovia); (2) action drug mechanism/anti-cytokine therapy (matrix metalloproteinase inhibitors, inhibitors of pro-inflammatory interleukins, etc.). The main delivery systems of drugs claiming to be of DMOADs status and possible contribution of immunological mechanisms to osteoarthritis pathogenesis are considered. Methods evaluating the effectiveness of DMOADs therapy are of great interest (cytology, microscopy, radiological research methods, blood and synovia biochemical markers). Based on research results analysis, the following substances can be considered as potential DMOADs: chondroitin sulfate, glucosamine sulfate, undenatured type II collagen, vitamin D. Each of them has symptom-modifying and structural-modifying effects.

В обзоре рассматриваются фармакологические средства, которые могут претендовать на статус потенциальных болезнь модифицирующих остеоартрит препаратов (англ. disease-modifying osteoarthritis drugs, DMOADs). DMOADs препятствуют прогрессированию и дальнейшему структурному повреждению сустава (структурно-модифицирующий эффект), приводя к уменьшению выраженности симптомов (симптом-модифицирующий эффект), таких как боль, и улучшению функции сустава. Обсуждаются подходы к выбору потенциальных DMOADs: 1) предпочтительная мишень (кость, хрящ, синовия); 2) механизм действия препарата / антицитокиновая терапия (ингибиторы матриксной металлопротеиназы, ингибиторы провоспалительных интерлейкинов и др.). Описаны основные системы доставки препаратов, претендующих на статус DMOADs, и возможный вклад иммунологических механизмов в патогенез остеоартрита. Большой интерес представляют методы оценки эффективности DMOADs-терапии (цитология, микроскопирование, радиологические методы исследования, биохимические маркеры крови и синовии). На основании проведенного анализа результатов исследований в качестве потенциальных DMOADs можно рассмотреть такие субстанции, как хондроитина сульфат, глюкозамина сульфат, неденатурированный коллаген II типа, витамин D. Каждая из них обладает симптом-модифицирующим и структурно-модифицирующим действием.

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The authors declare that there are no conflicts of interest present.