<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<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">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2018-12-98-104</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-2571</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>РЕВМАТОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>RHEUMATOLOGY</subject></subj-group></article-categories><title-group><article-title>Топические формы диклофенака в лечении заболеваний опорно-двигательного аппарата</article-title><trans-title-group xml:lang="en"><trans-title>Topical diclofenac for the treatment of the musculoskeletal diseases</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Имаметдинова</surname><given-names>Г. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Imametdinova</surname><given-names>G. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н.</p></bio><bio xml:lang="en"><p>PhD in medicine</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Иголкина</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Igolkina</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н.</p></bio><bio xml:lang="en"><p>PhD in medicine</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal budgetary state institution «Scientific research Institute of rheumatology named after V. A. Nasonova», Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>25</day><month>07</month><year>2018</year></pub-date><volume>0</volume><issue>12</issue><fpage>98</fpage><lpage>104</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Имаметдинова Г.Р., Иголкина Е.В., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Имаметдинова Г.Р., Иголкина Е.В.</copyright-holder><copyright-holder xml:lang="en">Imametdinova G.R., Igolkina E.V.</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://www.med-sovet.pro/jour/article/view/2571">https://www.med-sovet.pro/jour/article/view/2571</self-uri><abstract><p>Лечение заболеваний опорно-двигательного аппарата до настоящего времени остается не только серьезной медицинской, но и социально-экономической проблемой. Хронические заболевания суставов и позвоночника являются одной из наиболее частых причин инвалидизации пациентов. Основными клиническими проявлениями большинства заболеваний опорно-двигательного аппарата являются боль и воспаление, что требует проведения адекватной противовоспалительной терапии. Представлены данные о многообразных механизмах действия нестероидного противовоспалительного препарата (НПВП) диклофенак (Вольтарен), а также результаты клинических исследований и метаанализов, подтверждающих его эффективность и хорошую переносимость. Представлены данные экспериментальных и клинических исследований эффективности и безопасности локальных форм диклофенака – Вольтарен Эмульгель (диклофенака диэтиламин). Приводятся данные о форме Вольтарен Эмульгель 2% 12 часов. Показано, что широкий спектр анальгетического и  противо воспалительного действия диклофенака (Вольтарен) и хорошая переносимость позволяют использовать его в качестве симптоматической терапии в лечении заболеваний опорно-двигательного аппарата.</p><p> </p></abstract><trans-abstract xml:lang="en"><p>Treatment of diseases of the musculoskeletal system to date remains not only a serious medical, but also socio-economic problem. Chronic diseases of the joints and spine are one of the most common causes of disability in patients. The main clinical manifestations of most diseases of the musculoskeletal system are pain and inflammation, which requires adequate antiinflammatory therapy. The data on various mechanisms of action of non-steroidal anti-inflammatory drug (NSAID) diclofenac (Voltaren), as well as the results of clinical studies and meta-analyses confirming its effectiveness and good tolerability are presented. The data of experimental and clinical studies of the efficacy and safety of local forms of diclofenac-Voltaren Emulgel (diclofenac-diethylamine) –are presented. Provides information about the form of the Voltaren Emulgel 2% for 12 hours. It is shown that a wide range of analgesic and anti-inflammatory effects of diclofenac (Voltaren), and good tolerance can be used as symptomatic therapy in the treatment of diseases of the musculoskeletal system.</p><p> </p></trans-abstract><kwd-group xml:lang="ru"><kwd>нестероидные противовоспалительные препараты</kwd><kwd>заболевания опорно-двигательного аппарата</kwd><kwd>диклофенак</kwd><kwd>Вольтарен</kwd><kwd>Вольтарен Эмульгель</kwd></kwd-group><kwd-group xml:lang="en"><kwd>non-steroidal anti-inflammatory drugs</kwd><kwd>diseases of the musculoskeletal system</kwd><kwd>diclofenac</kwd><kwd>Voltaren</kwd><kwd>Voltaren Emulgel</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Насонов Е.Л., Яхно Н.Н., Каратеев А.Е. и соавт. Общие принципы лечения скелетно-мышечной боли: междисциплинарный консенсус. Научно-практическая ревматология, 2016, (54) 3: 247-65.</mixed-citation><mixed-citation xml:lang="en">Nasonov EL, Yakhno NN, Karateev AE, et al. General principles of treatment of musculoskeletal pain: interdisciplinary consensus. Nauchno-Prakticheskaya Revmatologiya, 2016, (54) 3: 247-65.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Верткин А.Л., Алексеева Л.И., Наумов А.В. и др. Остеоартроз в практике врача-терапевта. РМЖ, 2008, 16(7): 33-7.</mixed-citation><mixed-citation xml:lang="en">Vertkin AL, Alekseeva LI, Naumov AV. Osteoarthrosis in the practice of a physician. RMJ, 2008, 16 (7): 33-7.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">van Dijk GM, Veenhof C, Schellevis F, et al. Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee. BMS Musculoscelet Disord, 2008, Jun 26, 9: 95. doi: 10.1186/1471-2474-9-95.</mixed-citation><mixed-citation xml:lang="en">van Dijk GM, Veenhof C, Schellevis F, et al. Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee. BMS Musculoscelet Disord, 2008, Jun 26, 9: 95. doi: 10.1186/1471-2474-9-95.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Насонов Е.Л. Применение нестероидных противовоспалительных препаратов: терапевтические перспективы. РМЖ, 2002, 4(148): 206.</mixed-citation><mixed-citation xml:lang="en">Nasonov EL. The use of non-steroidal anti-inflammatory drugs: therapeutic prospects. RMJ, 2002, 4 (148): 206.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Каратеев А.Е., Насонов Е.Л., Яхно Н.Н., Ивашкин В.Т. и соавт. Рациональное использование нестероидных противовоспалительных препаратов (НПВП) в клинической практике. Клинические рекомендации. М., ИМА-Пресс, 2015.</mixed-citation><mixed-citation xml:lang="en">Karateev AE, Nasonov EL, Yakhno NN, Ivashkin VT, et al. Rational use of non-steroidal anti-inflammatory drugs (NSAIDs) in clinical practice. Clinical guidelines. IMA-Press, Moscow, 2015.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Рациональное использование нестероидных противовоспалительных препаратов. Междисциплинарный консенсус экспертов (основные положения) по результатам совещания группы экспертов 01.04.2017. М., Терапия, 2017, (4): 9-14.</mixed-citation><mixed-citation xml:lang="en">Rational use of non-steroidal anti-inflammatory drugs, interdisciplinary consensus of experts (main provisions) following the results of the expert group meeting 01/04/2017. Moscow. Terapiya, 2017, (4): 9-14</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Crofford LJ, Lipsky PE, Brooks P. et al. Basic biology and clinical application of specific cyclooxigenase-2 inhibitors. Arthritis Rheum, 2000, 43: 4-13.</mixed-citation><mixed-citation xml:lang="en">Crofford LJ, Lipsky PE, Brooks P. et al. Basic biology and clinical application of specific cyclooxigenase-2 inhibitors. Arthritis Rheum, 2000, 43: 4-13.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Насонова В.А. Вольтарен® (диклофенак натрия) в ревматологии в начале XXI века. РМЖ, 2004, 12(6): 1380-1385.</mixed-citation><mixed-citation xml:lang="en">Nasonova VA. Voltaren® (diclofenac sodium) in rheumatology at the beginning of the 21st century. RMJ, 2004, 12 (6): 1380-1385.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Насонов Е.Л. Нестероидные противовоспалительные препараты. Москва, 2000.</mixed-citation><mixed-citation xml:lang="en">Nasonov EL. Non-steroidal anti-inflammatory drugs. Moscow, 2000.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Рациональная фармакотерапия ревматических заболеваний под редакцией В.А. Насоновой, Е.Л. Насонова, 2003.</mixed-citation><mixed-citation xml:lang="en">Rational pharmacotherapy of rheumatic diseases edited by Nasonova VА, Nasonova EL, 2003.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Рисс В., Крупп П.Й. Фармакокинетика диклофенака у животных и человека. В кн.: Новые возможности клинического применения нестероидных противовоспалительных средств в ревматологии. М., 1976: 19-38.</mixed-citation><mixed-citation xml:lang="en">Riss V, Krupp PY. Pharmacokinetics of diclofenac in animals and humans. In the book: New possibilities of the clinical use of non-steroidal anti-inflammatory drugs in rheumatology. M., 1976: 19-38.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Насонов Е.Л. Нестероидные противовоспалительные препараты при ревматических заболеваниях: стандарт лечения. РМЖ, 2001, 9(7–8): 265–270.</mixed-citation><mixed-citation xml:lang="en">Nasonov EL. Nonsteroidal anti-inflammatory drugs for rheumatic diseases: standard of treatment. RMJ, 2001, 9 (7–8): 265-270.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Warner T, Mitchell J. Cyclooхygenases: new forms, new inhibitors, and lesson from the clinic. The Faseb J, 2004, 18: 790–804.</mixed-citation><mixed-citation xml:lang="en">Warner T, Mitchell J. Cyclooхygenases: new forms, new inhibitors, and lesson from the clinic. The Faseb J, 2004, 18: 790–804.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">O’Neill LA, Lewis GP. Inhibitory effects of diclofenac and indomethacin on interleukin-1-induced changes in PGE2 release. A novel effect on free arachidonic acid levels in human syno-vial cells. Biochem Pharmacol, 1989 Nov 1, 38(21): 3707-11.</mixed-citation><mixed-citation xml:lang="en">O’Neill LA, Lewis GP. Inhibitory effects of diclofenac and indomethacin on interleukin-1-induced changes in PGE2 release. A novel effect on free arachidonic acid levels in human syno-vial cells. Biochem Pharmacol, 1989 Nov 1, 38(21): 3707-11.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Meyer FA, Yaron I, Mashiah V, Yaron M. Effect of diclofenac on prostaglandin E and hyaluronic acid production by human synovial fibroblasts stimulated with interleukin-1. Br J Clin Pharmacol, 1989 Aug, 28(2): 193-6.</mixed-citation><mixed-citation xml:lang="en">Meyer FA, Yaron I, Mashiah V, Yaron M. Effect of diclofenac on prostaglandin E and hyaluronic acid production by human synovial fibroblasts stimulated with interleukin-1. Br J Clin Pharmacol, 1989 Aug, 28(2): 193-6.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Moilanen E. Effects of diclofenac, indomethacin, tolfenamic acid and hydrocortisone on prostanoid production in healthy and rheumatic synovial cells. Agents Actions, 1989 Mar, 26(3–4): 342-9.</mixed-citation><mixed-citation xml:lang="en">Moilanen E. Effects of diclofenac, indomethacin, tolfenamic acid and hydrocortisone on prostanoid production in healthy and rheumatic synovial cells. Agents Actions, 1989 Mar, 26(3–4): 342-9.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Giagoudakis G, Markantonis SL. Relationships between the concentrations of prostaglandins and the nonsteroidal antiinflammatory drugs indomethacin, diclofenac, and ibuprofen. Pharmacotherapy, 2005 Jan, 25(1): 18–25.</mixed-citation><mixed-citation xml:lang="en">Giagoudakis G, Markantonis SL. Relationships between the concentrations of prostaglandins and the nonsteroidal antiinflammatory drugs indomethacin, diclofenac, and ibuprofen. Pharmacotherapy, 2005 Jan, 25(1): 18–25.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Martinez LL, Aparecida De Oliveira M, Fortes ZB. Influence of verapamil and diclofenac on leukocyte migration in rats. Hypertension, 1999 Oct, 34(4 Pt 2): 997-1001.</mixed-citation><mixed-citation xml:lang="en">Martinez LL, Aparecida De Oliveira M, Fortes ZB. Influence of verapamil and diclofenac on leukocyte migration in rats. Hypertension, 1999 Oct, 34(4 Pt 2): 997-1001.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Gonzalez E, de la Cruz C, de Nicolas R, Egido J, Herrero–Beaumont G. Long–term effect of nonsteroidal anti–inflammatory drugs on the production of cytokines and other inflammatory mediators by blood cells of patients with osteoarthritis. Agents Actions, 1994 May, 41(3-4): 171-8.</mixed-citation><mixed-citation xml:lang="en">Gonzalez E, de la Cruz C, de Nicolas R, Egido J, Herrero–Beaumont G. Long–term effect of nonsteroidal anti–inflammatory drugs on the production of cytokines and other inflammatory mediators by blood cells of patients with osteoarthritis. Agents Actions, 1994 May, 41(3-4): 171-8.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Bell AL, Adamson H, Kirk F, McCaigue MD, Rotman H. Diclofenac inhibits monocyte super-oxide production ex vivo in rheumatoid arthritis. Rheumatol Int, 1991, 11(1): 27–30.</mixed-citation><mixed-citation xml:lang="en">Bell AL, Adamson H, Kirk F, McCaigue MD, Rotman H. Diclofenac inhibits monocyte super-oxide production ex vivo in rheumatoid arthritis. Rheumatol Int, 1991, 11(1): 27–30.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Ortiz MI, Granados-Soto V, Castaneda-Hernandez G. The NO-cGMP-K+ channel pathway participates in the antinociceptive effect of diclofenac, but not of indomethacin. Pharmacol Biochem Behav, 2003 Aug, 76(1): 187–95.</mixed-citation><mixed-citation xml:lang="en">Ortiz MI, Granados-Soto V, Castaneda-Hernandez G. The NO-cGMP-K+ channel pathway participates in the antinociceptive effect of diclofenac, but not of indomethacin. Pharmacol Biochem Behav, 2003 Aug, 76(1): 187–95.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Bjorkman RL, Hedner T, Hallman KM, Henning M, Hedner J. Localization of the central antinociceptive effects of diclofenac in the rat. Brain Res, 1992 Sep 11, 590(1–2): 66–73.</mixed-citation><mixed-citation xml:lang="en">Bjorkman RL, Hedner T, Hallman KM, Henning M, Hedner J. Localization of the central antinociceptive effects of diclofenac in the rat. Brain Res, 1992 Sep 11, 590(1–2): 66–73.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Edwards SR, Mather LE. Diclofenac increases the accumulation of kynurenate following tryptophan pretreatment in the rat: a possible factor contributing to its antihyperalgesic effect. Inflammopharmacology. 2003, 11(3): 277–92.</mixed-citation><mixed-citation xml:lang="en">Edwards SR, Mather LE. Diclofenac increases the accumulation of kynurenate following tryptophan pretreatment in the rat: a possible factor contributing to its antihyperalgesic effect. Inflammopharmacology. 2003, 11(3): 277–92.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Lee HM, Kim HI, Shin YK, Lee CS, Park M, Song JH. Diclofenac inhibition of sodium currents in rat dorsal root ganglion neurons. Brain Res, 2003 Nov 28, 992(1): 120–7.</mixed-citation><mixed-citation xml:lang="en">Lee HM, Kim HI, Shin YK, Lee CS, Park M, Song JH. Diclofenac inhibition of sodium currents in rat dorsal root ganglion neurons. Brain Res, 2003 Nov 28, 992(1): 120–7.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Lin Y, Mather LE, Power I, Cousins MJ. The effect of diclofenac on the expression of spinal cord c–fos–like immunoreactivity after ischemia– reperfusion–induced acute hyperalgesia in the rat tail. Anesth Analg, 2000 May, 90(5): 1141–5.</mixed-citation><mixed-citation xml:lang="en">Lin Y, Mather LE, Power I, Cousins MJ. The effect of diclofenac on the expression of spinal cord c–fos–like immunoreactivity after ischemia– reperfusion–induced acute hyperalgesia in the rat tail. Anesth Analg, 2000 May, 90(5): 1141–5.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Durigl T, Vitaus M, Pucar I, Mico M. Diclofenac sodium (Voltaren): Results of a multicenter comparative trial an adult-onset rheumatoid arthritis. J Int Med Res, 1975, 3: 139-144.</mixed-citation><mixed-citation xml:lang="en">Durigl T, Vitaus M, Pucar I, Mico M. Diclofenac sodium (Voltaren): Results of a multicenter comparative trial an adult-onset rheumatoid arthritis. J Int Med Res, 1975, 3: 139-144.</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Bijlsma A. The long-term efficacy and tolerability of Voltaren (diclofenac sodium) and indomethacin in rheumatoid arthritis. Scand J Rheumatol, 1978, 22: 74-80.</mixed-citation><mixed-citation xml:lang="en">Bijlsma A. The long-term efficacy and tolerability of Voltaren (diclofenac sodium) and indomethacin in rheumatoid arthritis. Scand J Rheumatol, 1978, 22: 74-80.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Rossi FA, Baroni L. A double-blind comparison between diclofenac sodium and ibuprofen in osteoarthrit. J Int Med Res, 1975, (3): 267-269.</mixed-citation><mixed-citation xml:lang="en">Rossi FA, Baroni L. A double-blind comparison between diclofenac sodium and ibuprofen in osteoarthrit. J Int Med Res, 1975, (3): 267-269.</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Смоленский В.С., Крель А.А., Янкин В.В. и соавт. Клиническая оценка эффективности вольтарена у больных ревматоидным артритом в сравнении с аспирином с применением слепого перекрестного метода. Новые возможности клинического применения нестероидных противовоспалительных средств в ревматологии. Доклады, представленные на симпозиуме, проходившем 9 июня 1976 года в Москве, 59-69.</mixed-citation><mixed-citation xml:lang="en">Smolensky VS, Krel AA, Yankin VV, et al. Clinical evaluation of the efficacy of voltaren in patients with rheumatoid arthritis in comparison with aspirin using a blind cross method. New possibilities of the clinical use of non-steroidal anti-inflammatory drugs in rheumatology. The papers presented at the symposium held on June 9, 1976 in Moscow, 59-69.</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">Чикколунги С.Н., Шубигер Б.И. Результаты клинических испытаний Вольтарена в различных странах. Новые возможности клинического применения нестероидных противовоспалительных средств в ревматологии. Доклады, представленные на симпозиуме, проходившем 9 июня 1976 года в Москве, 39-53.</mixed-citation><mixed-citation xml:lang="en">Chikolungi SN, Shubiger BI Results of the clinical trials of Voltaren in different countries. New possibilities of the clinical use of non-steroidal anti-inflammatory drugs in rheumatology. The papers presented at the symposium held on June 9, 1976 in Moscow, 39-53.</mixed-citation></citation-alternatives></ref><ref id="cit31"><label>31</label><citation-alternatives><mixed-citation xml:lang="ru">Комаров Ф.И., Савельев А., Шатрова И.Л. и соавт. Вольтарен в лечении заболеваний суставов. Новые возможности клинического применения нестероидных противовоспалительных средств в ревматологии. Доклады, представленные на симпозиуме, проходившем 9 июня 1976 года в Москве, 71-77.</mixed-citation><mixed-citation xml:lang="en">Komarov FI, Saveliev A, Shatrova IL, et al. Voltaren in the treatment of joint diseases. New possibilities of the clinical use of non-steroidal anti-inflammatory drugs in rheumatology. The papers presented at the symposium held on June 9, 1976 in Moscow, 71-77.</mixed-citation></citation-alternatives></ref><ref id="cit32"><label>32</label><citation-alternatives><mixed-citation xml:lang="ru">Крель А.А., Шехтер А.Б., Болотин Е.В. и соавт. Влияние вольтарена на некоторые лабораторные показатели активности ревматоидного артрита и морфологические проявления синовита. Новые возможности клинического применения нестероидных противовоспалительных средств в ревматологии. Доклады, представленные на симпозиуме, проходившем 9 июня 1976 года в Москве, 87-95</mixed-citation><mixed-citation xml:lang="en">Krel AA, Shekhter AB, Bolotin EV, et al. The effect of voltaren on some laboratory indicators of the rheumatoid arthritis activity and the morphological manifestations of synovitis. New possibilities of the clinical use of non-steroidal anti-inflammatory drugs in rheumatology. The papers presented at the symposium held on June 9, 1976 in Moscow, 87-95.</mixed-citation></citation-alternatives></ref><ref id="cit33"><label>33</label><citation-alternatives><mixed-citation xml:lang="ru">Singh G, Lanes S, Triadafilopoulos G. Risk of serious upper gastrointestinal and cardiovascular thromboembolic complications with meloxicam. Am J Med, 2004 Jul 15, 117(2): 100-6.</mixed-citation><mixed-citation xml:lang="en">Singh G, Lanes S, Triadafilopoulos G. Risk of serious upper gastrointestinal and cardiovascular thromboembolic complications with meloxicam. Am J Med, 2004 Jul 15, 117(2): 100-6.</mixed-citation></citation-alternatives></ref><ref id="cit34"><label>34</label><citation-alternatives><mixed-citation xml:lang="ru">Furst DE, Kolba KS, Fleischmann R. et.al. Dose response and safety study of meloxicam up to 22,5 mg daily in rheumatoid arthritis, a 12 week multicenter, double-blind, dose response study versus placebo and diclofenaс. J Rheum, 2002, 2: 436-446.</mixed-citation><mixed-citation xml:lang="en">Furst DE, Kolba KS, Fleischmann R. et.al. Dose response and safety study of meloxicam up to 22,5 mg daily in rheumatoid arthritis, a 12 week multicenter, double-blind, dose response study versus placebo and diclofenaс. J Rheum, 2002, 2: 436-446.</mixed-citation></citation-alternatives></ref><ref id="cit35"><label>35</label><citation-alternatives><mixed-citation xml:lang="ru">Laine L, Curtis SP, Cryer B, et.al. Assessment of upper gastrointestinal safety of eterocoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Eterocoxib and Diclofenac Arthritis Long Term (MEDAL) programme: a randomised comparison. Lancet, 2007, 369: 465-473.</mixed-citation><mixed-citation xml:lang="en">Laine L, Curtis SP, Cryer B, et.al. Assessment of upper gastrointestinal safety of eterocoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Eterocoxib and Diclofenac Arthritis Long Term (MEDAL) programme: a randomised comparison. Lancet, 2007, 369: 465-473.</mixed-citation></citation-alternatives></ref><ref id="cit36"><label>36</label><citation-alternatives><mixed-citation xml:lang="ru">Patrono C, Patrignani P, Garcia Rodriguez LA. Cyclooxygenase-selective inhibition of pros-tanoid formation transducing biochemical selectivity into clinical read-outs. J Clin Invest, 2001, 108: 7-13.</mixed-citation><mixed-citation xml:lang="en">Patrono C, Patrignani P, Garcia Rodriguez LA. Cyclooxygenase-selective inhibition of pros-tanoid formation transducing biochemical selectivity into clinical read-outs. J Clin Invest, 2001, 108: 7-13.</mixed-citation></citation-alternatives></ref><ref id="cit37"><label>37</label><citation-alternatives><mixed-citation xml:lang="ru">Reilly IAG, FitzGerald GA. Inhibition of thromboxane formation in vivo and ex vivo: implications for therapy with platelet inhibitory drugs. Blood, 1987, 69: 180-186.</mixed-citation><mixed-citation xml:lang="en">Reilly IAG, FitzGerald GA. Inhibition of thromboxane formation in vivo and ex vivo: implications for therapy with platelet inhibitory drugs. Blood, 1987, 69: 180-186.</mixed-citation></citation-alternatives></ref><ref id="cit38"><label>38</label><citation-alternatives><mixed-citation xml:lang="ru">Grosser T, Fries S, FitzGerald GA. Biological basis for the cardiovascular consequences of COX-2 inhibition: therapeutic challenges and opportunites. J Clin Invest, 2006, 116: 4-15.</mixed-citation><mixed-citation xml:lang="en">Grosser T, Fries S, FitzGerald GA. Biological basis for the cardiovascular consequences of COX-2 inhibition: therapeutic challenges and opportunites. J Clin Invest, 2006, 116: 4-15.</mixed-citation></citation-alternatives></ref><ref id="cit39"><label>39</label><citation-alternatives><mixed-citation xml:lang="ru">Gatella-Lawson F, Reilly MP, Kapoor SC, et.al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med, 2001, 345: 1809-1817.</mixed-citation><mixed-citation xml:lang="en">Gatella-Lawson F, Reilly MP, Kapoor SC, et.al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med, 2001, 345: 1809-1817.</mixed-citation></citation-alternatives></ref><ref id="cit40"><label>40</label><citation-alternatives><mixed-citation xml:lang="ru">Emery P, Zeidler H, Kiven KT, et.al. Celecoxib versus diclofenac in long-term management of rheumatoid arthritis: randomised double-blind comparison. Lancet, 1999, 354: 2106-2111.</mixed-citation><mixed-citation xml:lang="en">Emery P, Zeidler H, Kiven KT, et.al. Celecoxib versus diclofenac in long-term management of rheumatoid arthritis: randomised double-blind comparison. Lancet, 1999, 354: 2106-2111.</mixed-citation></citation-alternatives></ref><ref id="cit41"><label>41</label><citation-alternatives><mixed-citation xml:lang="ru">Sikes DH, Agrawal NM, Zhao WW. et.al. Incidence of gastroduodenal ulcers associated with valdecoxib compared with that of ibuprofen and diclofenac in patients with osteoarthritis. Eur J Gastroent Hepat,</mixed-citation><mixed-citation xml:lang="en">Sikes DH, Agrawal NM, Zhao WW. et.al. Incidence of gastroduodenal ulcers associated with valdecoxib compared with that of ibuprofen and diclofenac in patients with osteoarthritis. Eur J Gastroent Hepat,</mixed-citation></citation-alternatives></ref><ref id="cit42"><label>42</label><citation-alternatives><mixed-citation xml:lang="ru">Pavelka K, Recker DP, Verburg KM. Valdecoxib is as effective as diclofenac in the management of rheumatoid arthritis with a lower incidence of gastrointestinal ulcers: results of a 26-week trial. Rheum (Oxford),2003, 42: 1207-1215.</mixed-citation><mixed-citation xml:lang="en">Pavelka K, Recker DP, Verburg KM. Valdecoxib is as effective as diclofenac in the management of rheumatoid arthritis with a lower incidence of gastrointestinal ulcers: results of a 26-week trial. Rheum (Oxford),2003, 42: 1207-1215.</mixed-citation></citation-alternatives></ref><ref id="cit43"><label>43</label><citation-alternatives><mixed-citation xml:lang="ru">Shiokawa Y, Takatori M, Sakuma A. Multi-center trial of Voltaren (GP 45,840) on rheumatoid arthritis bu double-blind technique. J Jap Rheum Ass, 1972, 12: 271-275.</mixed-citation><mixed-citation xml:lang="en">Shiokawa Y, Takatori M, Sakuma A. Multi-center trial of Voltaren (GP 45,840) on rheumatoid arthritis bu double-blind technique. J Jap Rheum Ass, 1972, 12: 271-275.</mixed-citation></citation-alternatives></ref><ref id="cit44"><label>44</label><citation-alternatives><mixed-citation xml:lang="ru">Российские клинические рекомендации. Ревматология под редакцией академика РАН Е.Л. Насонова. М.: ГЭОТАР-Медиа, 2017. 464 с.</mixed-citation><mixed-citation xml:lang="en">Russian clinical guidelines. Rheumatology edited by academician of the Russian Academy of Sciences Nasonov EL. Moscow: GEOTAR-Media, 2017. 464 p.</mixed-citation></citation-alternatives></ref><ref id="cit45"><label>45</label><citation-alternatives><mixed-citation xml:lang="ru">Бадокин В.В. Нестероидные противовоспалительные препараты в локальной терапии ревматических заболеваний. Лечащий врач, 2010, (4): 72-74.</mixed-citation><mixed-citation xml:lang="en">Badokin VV. Non-steroidal anti-inflammatory drugs in local therapy for rheumatic diseases. Lechashchiy Vrach, 2010, (4): 72-74.</mixed-citation></citation-alternatives></ref><ref id="cit46"><label>46</label><citation-alternatives><mixed-citation xml:lang="ru">Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev, 2010, 6: CD007402.</mixed-citation><mixed-citation xml:lang="en">Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev, 2010, 6: CD007402.</mixed-citation></citation-alternatives></ref><ref id="cit47"><label>47</label><citation-alternatives><mixed-citation xml:lang="ru">Jorge L. Topical analgesics. Journal of Pain Research, 2011, 4: 11–24.</mixed-citation><mixed-citation xml:lang="en">Jorge L. Topical analgesics. Journal of Pain Research, 2011, 4: 11–24.</mixed-citation></citation-alternatives></ref><ref id="cit48"><label>48</label><citation-alternatives><mixed-citation xml:lang="ru">Sintov AC, Botner S. Transdermal drug delivery using microemulsion and aqueous systems: influence of skin storage conditions on the in vitro permeability of diclofenac from aqueous vehicle systems. Int J Pharm, 2006, 311(1-2): 55-62.</mixed-citation><mixed-citation xml:lang="en">Sintov AC, Botner S. Transdermal drug delivery using microemulsion and aqueous systems: influence of skin storage conditions on the in vitro permeability of diclofenac from aqueous vehicle systems. Int J Pharm, 2006, 311(1-2): 55-62.</mixed-citation></citation-alternatives></ref><ref id="cit49"><label>49</label><citation-alternatives><mixed-citation xml:lang="ru">Riess W, Schmid K, Botta L. et al. The percutaneous absorption of diclofenac. Arzneimittelforschung, 1986, 36(7): 1092-6.</mixed-citation><mixed-citation xml:lang="en">Riess W, Schmid K, Botta L. et al. The percutaneous absorption of diclofenac. Arzneimittelforschung, 1986, 36(7): 1092-6.</mixed-citation></citation-alternatives></ref><ref id="cit50"><label>50</label><citation-alternatives><mixed-citation xml:lang="ru">Radermacher J, Jentsch D, Scholl MA, Lustinetz T, Frolich JC. Diclofenac concentra-tions in synovial fluid and plasma after cutaneous application in inflammatory and degenertive joint disease. Br J Clin Pharmacol, 1991, 31(5): 537-541.</mixed-citation><mixed-citation xml:lang="en">Radermacher J, Jentsch D, Scholl MA, Lustinetz T, Frolich JC. Diclofenac concentra-tions in synovial fluid and plasma after cutaneous application in inflammatory and degenertive joint disease. Br J Clin Pharmacol, 1991, 31(5): 537-541.</mixed-citation></citation-alternatives></ref><ref id="cit51"><label>51</label><citation-alternatives><mixed-citation xml:lang="ru">Jondolph-Zink B, Gronwold U. Rheummatol, 1996, 6: 412-9.</mixed-citation><mixed-citation xml:lang="en">Jondolph-Zink B, Gronwold U. Rheummatol, 1996, 6: 412-9.</mixed-citation></citation-alternatives></ref><ref id="cit52"><label>52</label><citation-alternatives><mixed-citation xml:lang="ru">Garcia-Miranda R. Treatment of musculo-skeletal lesions in athletes with a new topic antiinflamatory: diethylammonium diclofenac, comparative double-blind study. Compend invest clin Latinoam, 1987, 7(3): 9-24.</mixed-citation><mixed-citation xml:lang="en">Garcia-Miranda R. Treatment of musculo-skeletal lesions in athletes with a new topic antiinflamatory: diethylammonium diclofenac, comparative double-blind study. Compend invest clin Latinoam, 1987, 7(3): 9-24.</mixed-citation></citation-alternatives></ref><ref id="cit53"><label>53</label><citation-alternatives><mixed-citation xml:lang="ru">Predel HG, Hamelsky S, Gold M, Giannetti B. Efficacy and safety of diclofenac diethylamine 2.32% gel in acute ankle sprain. Med Sci Sports Exerc, 201, 44(9): 1629-36. doi: 10.1249/ MSS.0b013e318257ed41.</mixed-citation><mixed-citation xml:lang="en">Predel HG, Hamelsky S, Gold M, Giannetti B. Efficacy and safety of diclofenac diethylamine 2.32% gel in acute ankle sprain. Med Sci Sports Exerc, 201, 44(9): 1629-36. doi: 10.1249/ MSS.0b013e318257ed41.</mixed-citation></citation-alternatives></ref><ref id="cit54"><label>54</label><citation-alternatives><mixed-citation xml:lang="ru">Predel HG, Giannetti B, Pabst H, Schaefer A, Hug AM, Burnett I. Efficacy and safety of diclofenac diethylamine 1.16% gel in acute neck pain: a randomized, doubleblind, placebocon-trolled study. BMC Musculoskelet Disord, 2013, 14(1): 250. https: doi.org/10.1186/14712474-14-250.</mixed-citation><mixed-citation xml:lang="en">Predel HG, Giannetti B, Pabst H, Schaefer A, Hug AM, Burnett I. Efficacy and safety of diclofenac diethylamine 1.16% gel in acute neck pain: a randomized, doubleblind, placebocon-trolled study. BMC Musculoskelet Disord, 2013, 14(1): 250. https: doi.org/10.1186/14712474-14-250.</mixed-citation></citation-alternatives></ref><ref id="cit55"><label>55</label><citation-alternatives><mixed-citation xml:lang="ru">González de Vega C, Speed C, Wolfarth B, González J. Traumeel vs. diclofenac for reducing pain and improving ankle mobility after acute ankle sprain: A multicentre, randomised, blinded, controlled and non-inferiority trial. Int J Clin Pract, 2013, 67(10): 979-989. https: doi. org/10.1111/ijcp.12219.</mixed-citation><mixed-citation xml:lang="en">González de Vega C, Speed C, Wolfarth B, González J. Traumeel vs. diclofenac for reducing pain and improving ankle mobility after acute ankle sprain: A multicentre, randomised, blinded, controlled and non-inferiority trial. Int J Clin Pract, 2013, 67(10): 979-989. https: doi. org/10.1111/ijcp.12219.</mixed-citation></citation-alternatives></ref><ref id="cit56"><label>56</label><citation-alternatives><mixed-citation xml:lang="ru">Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ. Topical NSAIDs for acute musculo-skeletal pain in adults. Cochrane Database of Syst Rev, 2015, 6: CD007402. doi: 10.1002/14651858.CD007402.pub3.</mixed-citation><mixed-citation xml:lang="en">Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ. Topical NSAIDs for acute musculo-skeletal pain in adults. Cochrane Database of Syst Rev, 2015, 6: CD007402. doi: 10.1002/14651858.CD007402.pub3.</mixed-citation></citation-alternatives></ref><ref id="cit57"><label>57</label><citation-alternatives><mixed-citation xml:lang="ru">Zacher J, Burger KJ, Farber L, Grave M, Abberger H, Bertsch K. Topisches Diclofenac Emulgel versus orales Ibuprofen in der Therapie der aktivierten Arthrose der Fingergelenke (Heberden- und/oder Bouchard-Arthrose). Akt Rheumatol, 2001, 26(1): 7-14. https: doi. org/10.1055/s-2001-11369.</mixed-citation><mixed-citation xml:lang="en">Zacher J, Burger KJ, Farber L, Grave M, Abberger H, Bertsch K. Topisches Diclofenac Emulgel versus orales Ibuprofen in der Therapie der aktivierten Arthrose der Fingergelenke (Heberden- und/oder Bouchard-Arthrose). Akt Rheumatol, 2001, 26(1): 7-14. https: doi. org/10.1055/s-2001-11369.</mixed-citation></citation-alternatives></ref><ref id="cit58"><label>58</label><citation-alternatives><mixed-citation xml:lang="ru">Niethard FU, Gold MS, Solomon GS, Liu JM, Unkauf M, Albrecht HH, Elkik F. Efficacy of topical diclofenac diethylamine gel in osteoarthritis of the knee. J Rheumatol, 2005 Dec, 32(12): 2384-92.</mixed-citation><mixed-citation xml:lang="en">Niethard FU, Gold MS, Solomon GS, Liu JM, Unkauf M, Albrecht HH, Elkik F. Efficacy of topical diclofenac diethylamine gel in osteoarthritis of the knee. J Rheumatol, 2005 Dec, 32(12): 2384-92.</mixed-citation></citation-alternatives></ref><ref id="cit59"><label>59</label><citation-alternatives><mixed-citation xml:lang="ru">Инструкция по применению лекарственного препарата для медицинского применения Вольтарена Эмульгеля. Гель для наружного применения 2%. Рег. № ЛП 002267-281116 от 28.11.2016 г. https: //www.rlsnet.ru/tn_index_ id_7427.htm.</mixed-citation><mixed-citation xml:lang="en">Patient Information Leaflet for a medicinal product for human use Voltaren Emulgel. Topical gel 2%. Reg. No. LP 002267-281116 dated 11/28/2016. Https: //www.rlsnet. ru/tn_index_ id_7427.htm</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
