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<article 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" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">The Clinician</journal-id><journal-title-group><journal-title xml:lang="en">The Clinician</journal-title><trans-title-group xml:lang="ru"><trans-title>Клиницист</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1818-8338</issn><issn publication-format="electronic">2412-8775</issn><publisher><publisher-name xml:lang="en">Publishing House ABV Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">618</article-id><article-id pub-id-type="doi">10.17650/1818-8338-2024-18-3-K723</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>PHARMACOTHERAPY</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ФАРМАКОТЕРАПИЯ</subject></subj-group><subj-group subj-group-type="article-type"><subject></subject></subj-group></article-categories><title-group><article-title xml:lang="en">Gout: possibilities of treatment optimization</article-title><trans-title-group xml:lang="ru"><trans-title>Подагра: возможности оптимизации лечения</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7410-9784</contrib-id><name-alternatives><name xml:lang="en"><surname>Klimenko</surname><given-names>A. A.</given-names></name><name xml:lang="ru"><surname>Клименко</surname><given-names>А. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Alesya Aleksandrovna Klimenko</p><p>1 Ostrovityanova St., Moscow 117997, Russia</p><p>8 Leninskiy Avenue, Moscow 117049, Russia</p></bio><bio xml:lang="ru"><p>Алеся Александровна Клименко</p><p>117997 Москва, ул. Островитянова, 1</p><p>117049 Москва, Ленинский просп., 8</p></bio><email>aaklimenko@yandex.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4669-1006</contrib-id><name-alternatives><name xml:lang="en"><surname>Shostak</surname><given-names>N. A.</given-names></name><name xml:lang="ru"><surname>Шостак</surname><given-names>Н. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>1 Ostrovityanova St., Moscow 117997, Russia</p></bio><bio xml:lang="ru"><p>117997 Москва, ул. Островитянова, 1</p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8266-6022</contrib-id><name-alternatives><name xml:lang="en"><surname>Andriyashkina</surname><given-names>D. A.</given-names></name><name xml:lang="ru"><surname>Андрияшкина</surname><given-names>Д. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>1 Ostrovityanova St., Moscow 117997, Russia</p></bio><bio xml:lang="ru"><p>117997 Москва, ул. Островитянова, 1</p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9152-3234</contrib-id><name-alternatives><name xml:lang="en"><surname>Kondrashov</surname><given-names>A. A.</given-names></name><name xml:lang="ru"><surname>Кондрашов</surname><given-names>А. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>1 Ostrovityanova St., Moscow 117997, Russia</p></bio><bio xml:lang="ru"><p>117997 Москва, ул. Островитянова, 1</p></bio><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">N.I. Pirogov National Research Medical University, Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">N.I. Pirogov City Clinical Hospital No.1, Moscow Healthcare Department</institution></aff><aff><institution xml:lang="ru">ГБУЗ города Москвы «Городская клиническая больница №1 им. Н.И. Пирогова Департамента здравоохранения города Москвы»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2024-07-15" publication-format="electronic"><day>15</day><month>07</month><year>2024</year></pub-date><volume>18</volume><issue>3</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>69</fpage><lpage>78</lpage><history><date date-type="received" iso-8601-date="2024-11-30"><day>30</day><month>11</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2024-11-30"><day>30</day><month>11</month><year>2024</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2024, Klimenko A.A., Shostak N.A., Andriyashkina D.A., Kondrashov A.A.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2024, Клименко А.А., Шостак Н.А., Андрияшкина Д.А., Кондрашов А.А.</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="en">Klimenko A.A., Shostak N.A., Andriyashkina D.A., Kondrashov A.A.</copyright-holder><copyright-holder xml:lang="ru">Клименко А.А., Шостак Н.А., Андрияшкина Д.А., Кондрашов А.А.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://klinitsist.abvpress.ru/Klin/article/view/618">https://klinitsist.abvpress.ru/Klin/article/view/618</self-uri><abstract xml:lang="en"><p>Aim. To consider new mechanisms of gout pathogenesis of and possibilities of influencing the pathological process. Gout is a chronic joint disease caused by the deposition of monosodium urate crystals in various tissues and subsequent inflammation in individuals with hyperuricemia, caused by exocrine and/or genetic factors. In recent years, new knowledge about gout diagnostics, genetics, pathogenesis, comorbidities and various data indicate new strategies to improve control of the disease and its exacerbations, as well as to prevent comorbid conditions. The discovery of new mechanisms concerning sodium monourate crystal-induced inflammation, proposed new methods of treating not only gout, but also other systemic diseases, including renal and cardiovascular diseases using xanthine oxidase inhibitors, including febuxostat. The case of colchicine is very indicative, which recently, taking into account the significant results of laboratory and clinical experiments, received approval from the US Federal Food and Drug Administration for the Prevention of cardiovascular Diseases. This has provided opportunities for the combinedadministration of febuxostat and colchicine to treat gout, recurrent arthritis attacks and reduce the risk of cardiovascular complications.</p></abstract><trans-abstract xml:lang="ru"><p>Цель обзора - рассмотрение новых механизмов патогенеза подагры и возможностей влияния на патологический процесс. одагра - хроническое заболевание суставов, которое вызвано отложением кристаллов моноурата натрия в различных тканях и развивающимся в связи с этим воспалением, у лиц с гиперурикемией, обусловленной внешнесекреторными и/или генетическими факторами. За последние годы новые знания о диагностике, генетических особенностях подагры, патогенезе, сопутствующих заболеваниях и клинических данных позволили выявить новые стратегии для улучшения контроля заболевания и его обострений, а также профилактики коморбидных состояний. С открытием новых механизмов, касающихся вызванного кристаллами моноурата натрия воспаления, предложены новые способы лечения не только подагры, но и других системных заболеваний (включая почечные и сердечнососудистые) с применением ингибиторов ксантиноксидазы, в том числе фебуксостата. Весьма показателен случай колхицина, который недавно, с учетом значимых результатов лабораторных и клинических экспериментов, получил одобрение едерального управления США по надзору за качеством продуктов питания и лекарственных средств для профилактики сердечно-сосудистых заболеваний, что открыло возможности комбинированного назначения фебуксостата и колхицина для лечения подагры, рецидивов приступов артрита и снижения риска сердечно-сосудистых осложнений.</p></trans-abstract><kwd-group xml:lang="en"><kwd>gout</kwd><kwd>gouty arthritis</kwd><kwd>chronic kidney disease</kwd><kwd>diabetes mellitus</kwd><kwd>colchicine</kwd><kwd>xanthine oxidase inhibitor</kwd><kwd>febuxostat</kwd><kwd>allopurinol</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>подагра</kwd><kwd>подагрический артрит</kwd><kwd>хроническая болезнь почек</kwd><kwd>сахарный диабет</kwd><kwd>колхицин</kwd><kwd>ингибитор ксантиноксидазы</kwd><kwd>фебуксостат</kwd><kwd>аллопуринол</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Dehlin M., Jacobsson L., Roddy E. 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