[Symptomatic slow-acting drugs in the treatment of osteoarthritis: focus on glucosamine preparations]. / Simptomaticheskie lekarstvennye sredstva zamedlennogo deistviya pri lechenii osteoartrita: fokus na preparaty glyukozamina.

The article discusses the place of symptomatic slow-acting drugs in current guidelines for the treatment of osteoarthritis. Special emphasis is put ot glucosamine preparations, the attitude towards which, until recently, was ambiguous. The results of experimental and clinical studies demonstrating the advantages of crystalline glucosamine sulfate over preparations/food additives of glucosamine hydrochloride are presented. The differences in the pharmacodynamics and pharmacokinetics of glucosamine sulfate and glucosamine hydrochloride, which may be the reason for the ineffectiveness of the latter in clinical trials, are discussed.

[Muramyldipeptide - based compounds in current medicine: focus on glucosaminylmuramyl dipeptide].

The role of immune mechanisms in the pathogenesis of almost all human diseases shown in recent decades, increase in antibiotic resistance and secondary immunodeficiency, aging of the population and widespread use of immunosuppressive drugs and procedures suggest a wider use of immunomodulators in current clinical practice, but the use of most of them limits the lack of knowledge. The most promising compounds for the development as immunomodulating agents and adjuvants for a wide range of vaccines are low molecular weight fragments of peptidoglycan - muramylpeptides. The article describes the mechanisms of action of muramylpeptides, their biological effects and properties of medicines developed on their basis. Special emphasis is placed to glucosaminylmuramyl dipeptide registered in the Russian Federation under the trade name Likopid, which is currently the best - studied drug in its group. The results of Likopid studies when used as a prophylactic and therapeutic agent for infections of various localization in adults and children, for oncological diseases and complications of chemotherapy and radiation therapy, psoriasis, atopic and other diseases are presented. It is emphasized that in diseases associated with human papillomavirus and plaque psoriasis, according to current criteria of evidence - based medicine, Likopid should be classified as drug with level A efficacy (high efficiency in 80-100% of patients). High safety of Likopid in adults and children, including newborns, is noted.

Methods of Pharmacological Treatment of Chronic Thromboembolic Pulmonary Hypertension Current Approaches to the Patients Management.

In this paper we have discussed epidemiology, pathogenesis, and approaches to treatment of chronic thromboembolic pulmonary hypertension (CTEPH). CTEPH is a unique potentially curable form of pulmonary hypertension. The gold standard of CTEPH treatment is pulmonary thromboendarterectomy. However, about 40% of patients with CTEPH are inoperable due to distal surgically inaccessible lesions of the pulmonary vasculature, severe hemodynamic impairments, or other contraindications. In addition, nearly half of patients have persistent or recurrent pulmonary hypertension following surgery. Current guidelines support the use of pharmacotherapy in these patients. In the article we have presented results of main clinical studies of targeted drugs therapy (endothelin receptor antagonists, prostanoids, phosphodiesterase type 5 inhibitors, soluble guanylate cyclase stimulators) of patients with CTEPH. The only drug that has demonstrated robust clinical efficacy in terms of improvment hemodynamic parameters, exercise capacity and patients' quality of life is the stimulator of the soluble guanylate cyclase riociguat. The efficacy and safety of riociguat have been investigated in short-term and long-term studies with follow-up up to 6 years. Results of these studies have constituted the basis forits approval by the regulatory authorities of more than 50 countries for the treatment of inoperable CTEPH and persistent or recurrent CTEPH after pulmonary thromboendarterectomy. In the European Union, USA and many other countries, riociguat is the only pharmacological agent approved for these indications.

INTERCHANGEABILITY OF VIRAL VACCINES FOR IMMUNIZATION.

The review presents the results of the analysis of domestic and foreign scientific literature on the interchangeability of hepatitis A, B and influenza vaccines. The WHO materials, regulatory documents, data from scientific literature of foreign countries and Russia about the vaccine interchangeability are summarized. The problem of objective assessment of interchangeability of drugs is relevant worldwide. The definition of an "interchangeable drug" does not draw a clear line between the interoperability criteria for chemical and immunobiological drugs. The official guidance documents on immunization adopted in several countries define "interchangeability" as the practice of transition from a vaccine available from a certain manufacturer to a similar vaccine available from another manufacturer. The term "interchangeable" can be applied to immunobiological drugs if one of the drugs can be replaced with the other in the course of vaccination. The concept of interchangeability applies to vaccines that do not differ in efficacy (immunological, preventive, epidemiological) and safety and are used in an immunization course involving multiple administration of these vaccines. The definition of interchangeability is important in order to address the problem of replacing unidirectional vaccines available from different manufacturers when purchasing vaccines included in the national schedule of preventive vaccinations and in the schedule of preventive vaccination on epidemic indications. One of the most important conditions for "interchangeability" of vaccines is their application in accordance with the recommended schedule of administration and the dosage indicated by the manufacturer. Research data show that vaccines can be interchangeable if used in accordance with the recommended schedule of administration and the dosage specified by the manufacturer. Control agencies of many countries issue recommendations regulating the procedure of vaccine replacement in case of necessity. However, there are no special regulations of vaccine interchangeability in Russia. The concept of vaccine "interchangeability" should be extended to the continuation of a course of vaccinations in a particular person with a vaccine of another manufacturer and the possibility of applying similar vaccines available from different manufacturers.