medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-172medsovet-10265Research ArticleАЛЛЕРГОЛОГИЯ И ИММУНОЛОГИЯALLERGOLOGY AND IMMUNOLOGYВыбор антигистаминного препарата у пациентов с аллергическими заболеваниямиChoosing an antihistamine for patients with allergic diseaseshttps://orcid.org/0000-0003-2682-8108ПередельскаяМ. Ю.PeredelskayaM. Yu.

Передельская Марина Юрьевна - к.м.н., доцент кафедры аллергологии и иммунологии, Российская МАППО; врач – аллерголог-иммунолог, Городская клиническая больница №24

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1; 127015, Москва, ул. Писцовая, д. 10

Marina Yu. Peredelskaya - Cand. Sci. (Med.), Associate Professor of the Department of Allergology and Immunology, Russian Medical Academy of Continuous Professional Education; Allergist-Immunologist, City Clinical Hospital No. 24.

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993; 10, Pistsovaya St., Moscow, 127015

concy1984@gmail.comhttps://orcid.org/0000-0002-3162-2510НенашеваН. М.NenashevaN. M.

Ненашева Наталья Михайловна - д.м.н., профессор, заведующая кафедрой аллергологии и иммунологии.

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Natalia M. Nenasheva - Dr. Sci. (Med.), Professor, Head of the Department of Allergology and Immunology.

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

1444031@gmail.comhttps://orcid.org/0009-0002-1865-5024БеликО. А.BelikO. A.

Белик Ольга Алексеевна - врач-ординатор кафедры аллергологии и иммунологии.

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Olga A. Belik - Resident Physician of the Department of Allergology and Immunology.

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

olgabelik13@gmail.comhttps://orcid.org/0000-0002-3508-9602СебекинаО. В.SebekinaO. V.

Себекина Оксана Владимировна - к.м.н., доцент кафедры аллергологии и иммунологии, Российская МАППО; врач – аллерголог-иммунолог, Городская клиническая больница №24.

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1; 127015, Москва, ул. Писцовая, д. 10

Oksana V. Sebekina - Cand. Sci. (Med.), Associate Professor of the Department of Allergology and Immunology, RMA of Continuous Professional Education; Allergist-Immunologist, City Clinical Hospital No. 24.

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993; 10, Pistsovaya St., Moscow, 127015

sebekin1@mail.ruhttps://orcid.org/0009-0006-7116-9091НасуноваА. Ю.NasunovaA. Yu.

Насунова Айса Юрьевна - к.м.н., ассистент кафедры аллергологии и иммунологии.

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Aisa Yu. Nasunova - Cand. Sci. (Med.), Assistant Professor of the Department of Allergology and Immunology.

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

aysulia@mail.ruРоссийская медицинская академия непрерывного профессионального образования; Городская клиническая больница №24РоссияRussian Medical Academy of Continuous Professional Education; City Clinical Hospital No. 24Russian FederationРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian Federation20261407202609200207Copyright © Передельская М.Ю., Ненашева Н.М., Белик О.А., Себекина О.В., Насунова А.Ю., 20262026Передельская М.Ю., Ненашева Н.М., Белик О.А., Себекина О.В., Насунова А.Ю.Peredelskaya M.Y., Nenasheva N.M., Belik O.A., Sebekina O.V., Nasunova A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/10265

В статье рассматриваются вопросы рационального выбора Н1-антигистаминных препаратов (Н1-АГП) для терапии аллергических заболеваний, преимущественно аллергического ринита (АР) и крапивницы. Описаны современные представления о патогенетических механизмах аллергии, включая роль гистамина и иммуноглобулина E, а также ключевые патофизиологические процессы, определяющие формирование аллергических реакций. Особое внимание уделено дифференциации Н1-АГП по их фармакологическим свойствам и влиянию на центральную нервную систему, что имеет особое значение для лиц определенных профессий и пожилого возраста, с указанием исследований и данных о конкретных аспектах этого влияния. Авторами акцентируется необходимость отказа от применения седативных препаратов I поколения в пользу современных неседативных Н1-АГП с более благоприятным профилем безопасности. В качестве примера высокоэффективного и безопасного Н1-АГП II поколения рассмотрен эбастин: приведены его фармакокинетические параметры, результаты рандомизированных клинических исследований при АР и различных формах крапивницы, а также профиль переносимости, характеризующийся минимальным риском развития когнитивных нарушений, в том числе при долгосрочном применении и при использовании в дозах, превышающих терапевтические. Представлены аргументы в пользу обоснованности использования эбастина в качестве препарата первой линии у лиц старше 12 лет, а также данные о биоэквивалентности отечественного препарата Аллергостин оригинальному лекарственному средству. В заключение отмечается, что неседативные Н1-АГП II поколения, такие как эбастин, обладают оптимальным балансом эффективности и безопасности и рекомендуются для лечения аллергических заболеваний в соответствии с действующими федеральными и международными клиническими рекомендациями.

The article discusses the issues of rational choice of H1-antihistamines (H1-AHs) in the treatment of allergic diseases, mainly allergic rhinitis (AR) and urticaria. Modern ideas about the pathogenetic mechanisms of allergy are described, including the role of histamine and immunoglobulin E, as well as key pathophysiological processes that determine the formation of allergic reactions. Particular attention is paid to the differentiation of H1-AHs by pharmacological properties, their effect on the central nervous system, which is of particular importance for people of certain professions and the elderly, indicating studies and data on specific aspects of this effect. The authors emphasize the need to abandon the use of first-generation sedatives in favor of modern non-sedative H1-AHs with a more favorable safety profile. As an example of a highly effective and safe H1-Ahs of the second generation, ebastine is considered: its pharmacokinetic parameters, the results of randomized clinical trials in AR and various forms of urticaria, as well as a tolerability profile characterized by a minimal risk of cognitive impairment, including long-term use and when used in doses higher than therapeutic, are presented. Arguments in favor of the validity of the use of ebastin as a first-line drug in patients over 12 years of age are presented, as well as data on the bioequivalence of the domestic drug Allergostin to the original drug. The conclusion notes that second-generation non-sedative H1-AHs, such as ebastine, have an optimal balance between efficacy and safety and are recommended for the treatment of allergic diseases in accordance with current federal and international clinical guidelines.

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