medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-23-68-77medsovet-7296Research ArticleНЕВРОЛОГИЯNEUROLOGYОбщая характеристика и особенности применения нестероидных противовоспалительных препаратов при лечении дорсопатий в клинической практике (обзор литературы)General characteristics and features of the use of nonsteroidal anti-inflammatory drugs in the treatment of dorsopathies in clinical practice (literature review)https://orcid.org/0000-0002-8435-7562ЯковлевЕ. В.YakovlevE. V.

Яковлев Евгений Васильевич - кандидат медицинских наук, доцент, заведующий неврологическим отделением, МЦ «Адмиралтейские верфи»; заведующий кафедрой психофизиологии, Институт прикладного психоанализа и психологии; доцент кафедры фундаментальных медицинских дисциплин, МГОПУ.

190121, Санкт-Петербург, ул. Садовая, д. 126; 199226, Санкт-Петербург, Галерный проезд, д. 3; 141014, Московская область, Мытищи, ул. Веры Волошиной, д. 24

Evgeny V. Yakovlev - Cand. Sci. (Med.), Associate Professor, Head of the Neurological Department, Мedical Center “Admiralteyskie Verfi”; Head of the Department of Psychophysiology, Institute of Applied Psychoanalysis and Psychology; Associate Professor of the Department of Fundamental Medical Disciplines, Moscow State Regional Pedagogical University.

126, Sadovaya St., St Petersburg, 190121; 3, Galerniy Рroezd, St Petersburg, 199226; 24, Vera Voloshina St., Moscow Region, Mytishchi, 141014

vmeda-ev@mail.ruhttps://orcid.org/0000-0003-0363-102XЖиволуповС. А.ZhivolupovS. A.

Живолупов Сергей Анатольевич - доктор медицинских наук, профессор, профессор кафедры нервных болезней.

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Sergey A. Zhivolupov - Dr. Sci. (Med.), Professor, Professor of the Department of Nervous Diseases, Military Medical Academy named after S.M. Kirov.

6, Akademik Lebedev St., St Petersburg, 194044

peroslava@yandex.ruhttps://orcid.org/0000-0001-9671-462XГневышевЕ. Н.GnevyshevE. N.

Гневышев Евгений Николаевич - кандидат медицинских наук, доцент кафедры психофизиологии, Институт прикладного психоанализа и психологии; начальник неврологического отделения, Третий ВГ войск национальной гвардии РФ;

199226, Санкт-Петербург, Галерный проезд, д. 3; 192171, Санкт-Петербург, ул. Цимбалина, д. 13

Evgeniy N. Gnevyshev - Cand. Sci. (Med.), Associate Professor of the Department of Psychophysiology, Institute of Applied Psychoanalysis and Psychology; Head of the Neurological Department, Тhird Military Hospital of the Russian National Guard Troops.

3, Galerniy Рroezd, St Petersburg, 199226; 13, Tsimbalin St., St Petersburg, 192171

gnevyshev@yandex.ruhttps://orcid.org/0000-0001-7446-5060ВетроваТ. В.VetrovaT. V.

Ветрова Татьяна Вячеславовна - кандидат психологических наук, доцент кафедры психофизиологии.

199226, Санкт-Петербург, Галерный проезд, д. 3

Tatiana V. Vetrova - Cand. Sci. (Psychol.), Associate Professor of Department of Psychophysiology, Institute of Applied Psychoanalysis and Psychology.

3, Galerniy Рroezd, St Petersburg, 199226

doretat@rambler.ruМедицинский центр «Адмиралтейские верфи»; Институт прикладного психоанализа и психологии; Московский государственный областной педагогический университетРоссияMedical Center “Admiralteyskie Verfi”; Institute of Applied Psychoanalysis and Psychology; Moscow State Regional Pedagogical UniversityRussian FederationВоенно-медицинская академия имени С.М. КироваРоссияMilitary Medical Academy named after S.M. KirovRussian FederationИнститут прикладного психоанализа и психологии; Третий Военный госпиталь войск национальной гвардии РФРоссияInstitute of Applied Psychoanalysis and Psychology; Тhird Military Hospital of the Russian National Guard TroopsRussian FederationИнститут прикладного психоанализа и психологииРоссияInstitute of Applied Psychoanalysis and PsychologyRussian Federation2022180120230236877Copyright © Яковлев Е.В., Живолупов С.А., Гневышев Е.Н., Ветрова Т.В., 20232023Яковлев Е.В., Живолупов С.А., Гневышев Е.Н., Ветрова Т.В.Yakovlev E.V., Zhivolupov S.A., Gnevyshev E.N., Vetrova T.V.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/7296

Боль в спине занимает первое место среди всех неинфекционных заболеваний по количеству лет жизни, потерянных вследствие ухудшения здоровья. При этом выбор тактики лечения дорсопатий представляет определенные трудности, в частности выбор нестероидного противовоспалительного препарата (НПВП), который зависит от ряда факторов. НПВП эффективно используются в терапии скелетно-мышечных болей, однако они обладают побочными эффектами, что определяет индивидуальные особенности их применения. В статье представлен обзор научных данных, опубликованных в источниках MEDLINE, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Clinical Trials.gov, служб обмена исследовательской информацией по клинической практике применения НПВП. Проанализирована общая характеристика, побочные эффекты НПВП в клинической практике с целью выбора эффективной и безопасной траектории их применения при лечении дорсопатий. В остром периоде дорсопатии лечебное воздействие должно быть направлено в первую очередь на уменьшение боли. При этом применение НПВП является необходимым и оправданным, должно включать детальную оценку побочных эффектов, длительность применения, альтернативные траектории медикаментозного и немедикаментозного лечения. Многочисленные побочные эффекты НПВП со стороны желудочно-кишечного тракта, печени, сердечно-сосудистой системы, аллергические реакции, врожденные аномалии у плода при применении НПВП во время беременности и другие нежелательные последствия заставляют предпринимать максимально возможные меры с целью минимизации побочных реакций и отдаленных нежелательных последствий для пациента. Комбинированное терапевтическое воздействие, включающее, наряду с применением НПВП, физиотерапию, лечебную физическую культуру, массаж, рефлексотерапию, оптимизацию двигательной активности, оптимизацию позы при статических нагрузках, применение методов когнитивно-поведенческой терапии, является оптимальным с позиции стратификации рисков и ожидаемого клинического эффекта у пациентов с дорсопатией.

Back pain ranks first among all non-communicable diseases in terms of the number of years of life lost due to poor health. At the same time, the choice of tactics for the treatment of dorsopathies presents certain difficulties, in particular, the choice of a nonsteroidal anti-inflammatory drug (NSAID), which depends on a number of factors. NSAIDs are effectively used in the treatment of musculoskeletal pain, but they have side effects, which determines the individual characteristics of their use. The article presents an overview of scientific data published in the sources MEDLINE, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Clinical Trials.gov, services for the exchange of research information on the clinical practice of NSAID use. The general characteristics and side effects of NSAIDs in clinical practice are analyzed in order to choose an effective and safe trajectory of their use in the treatment of dorsopathies. In the acute period of dorsopathy, the therapeutic effect should be aimed primarily at reducing pain. At the same time, the use of NSAIDs is necessary and justified, should include a detailed assessment of side effects, duration of use, alternative trajectories of drug and non-drug treatment. Numerous side effects of NSAIDs from the gastrointestinal tract, liver, cardiovascular system, allergic reactions, congenital anomalies in the fetus when using NSAIDs during pregnancy and other undesirable consequences, make it necessary to take the maximum possible measures to minimize adverse reactions and long-term undesirable consequences for the patient. Combined therapeutic effects, including, along with the use of NSAIDs, physiotherapy, physical therapy, massage, reflexotherapy, optimization of motor activity, optimization of posture under static loads, the use of cognitive behavioral therapy methods, is optimal from the standpoint of risk stratification and the expected clinical effect in patients with dorsopathy.

дорсопатииболь в спинескелетно-мышечные болинестероидные противовоспалительные препаратыпобочные эффекты НПВПdorsopathyback painmusculoskeletal painnonsteroidal anti-inflammatory drugsside effects of NSAIDsReferencesПодчуфарова Е.В. Актуальные вопросы острой и хронической боли в пояснично-крестцовой области. Неврология, нейропсихиатрия, психосоматика. 2012;(1):27–35. https://doi.org/10.14412/2074-2711-2012-358.Podchufarova E.V. Acute and chronic lumbosacral pain: Topical problems. Neurology, Neuropsychiatry, Psychosomatics. 2012;(1):27–35. (In Russ.) https://doi.org/10.14412/2074-2711-2012-358.Парфенов В.А. Комитет по боли в спине. Opinion Leader. 2019;(6)20–22. Режим доступа: https://www.elibrary.ru/item.asp?id=44131309.Parfenov V.A. Committee on Back Pain. Opinion Leader. 2019;(6):20–22. (In Russ.) Available at: https://www.elibrary.ru/item.asp?id=44131309.Dieleman J.L., Cao J., Chapin A., Chen C., Li Z., Liu A. et al. US Health Care Spending by Payer and Health Condition, 1996–2016. JAMA. 2020;323(9):863–884. https://doi.org/10.1001/jama.2020.0734.Dieleman J.L., Cao J., Chapin A., Chen C., Li Z., Liu A. et al. US Health Care Spending by Payer and Health Condition, 1996–2016. JAMA. 2020;323(9):863–884. https://doi.org/10.1001/jama.2020.0734.Живолупов С.А., Самарцев И.Н., Яковлев Е.В. Болевые синдромы в клинической практике врача-невролога: патофизиология и принципы фармакотерапии. Клиническая фармакология и терапия. 2017;(5):10–18. Режим доступа: https://clinpharm-journal.ru/articles/2017-5/bolevye-sindromy-v-klinicheskoj-praktike-vracha-nevrologa-patofiziologiya-i-printsipy-farmakoterapii/?ysclid=l8xhk9mzor505085980.Zhivolupov S.A., Samartsev I.N., Yakovlev E.V. Pain syndromes in clinical practice of a neurologist: pathophysiology and principles of pharmacotherapy. Clinical Pharmacology and Therapy. 2017;(5):10–18. (In Russ.) Available at: https://clinpharm-journal.ru/articles/2017-5/bolevye-sindromy-v-klinicheskoj-praktike-vracha-nevrologa-patofiziologiya-i-printsipy-farmakoterapii/?ysclid=l8xhk9mzor505085980.Яковлев Е.В., Леонтьев О.В., Живолупов С.А., Гневышев Е.Н., Смирнов А.А., Живолупов Ю.А., Самарцев И.Н. Сравнительная характеристика клинической эффективности оригинального препарата Мовалис и Амелотекса в лечении неспецифической поясничной боли. Журнал неврологии и психиатрии им. С.С. Корсакова. 2020;(7):56–62. https://doi.org/10.17116/jnevro202012007156.Yakovlev E.V., Leontiev O.V., Zhivolupov S.A., Gnevyshev E.N., Smirnov A.A., Zhivolupova Y.A., Samartcev I.N. Comparative characteristic of clinical efficacy of the original drug Movalis and its generic Amelotex in the treatment of non-specific lumbar pain. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2020;(7):56–62. (In Russ.) https://doi.org/10.17116/jnevro202012007156.Яковлев Е.В., Гневышев Е.Н., Живолупов С.А., Смирнов А.А., Живолупова Ю.А., Ерисковская А.И., Овсепьян А.Л. Оценка терапевтической эффективности оригинального и дженерического мелоксикама в лечении острой боли в шее. Медицинский совет. 2021;(21):25–33. https://doi.org/10.21518/2079-701X-2021-21-1-25-33.Yakovlev E.V., Gnevyshev E.N., Zhivolupov S.A., Smirnov A.A., Zhivolupova Yu.A., Eriskovskaya A.I., Ovsepyan A.L. Evaluation of the therapeutic efficacy of original and generic meloxicam in the treatment of acute neck pain. Meditsinskiy Sovet. 2021;(21):25–33. (In Russ.) https://doi.org/10.21518/2079-701X-2021-21-1-25-33.Phillips W.J., Currier B.L. Analgesic pharmacology: II. Specific analgesics. J Am Acad Orthop Surg. 2004;12(4):221–233. https://doi.org/10.5435/00124635-200407000-00003.Phillips W.J., Currier B.L. Analgesic pharmacology: II. Specific analgesics. J Am Acad Orthop Surg. 2004;12(4):221–233. https://doi.org/10.5435/00124635-200407000-00003.Каратеев A.E., Насонов Е.Л., Яхно Н.Н., Ивашкин В.Т., Чичасова Н.В., Алексеева Л.И. и др. Клинические рекомендации «Рациональное применение нестероидных противовоспалительных препаратов (НПВП) в клинической практике». Современная ревматология. 2015;(1):4–23. https://doi.org/10.14412/1996-7012-2015-1-4-23.Karateev A.E., Nasonov E.L., Yakhno N.N., Ivashkin V.T., Chichasova N.V., Alekseeva L.I. et al. Clinical guidelines “Rational use of nonsteroidal anti-inflammatory drugs (NSAIDs) in clinical practice”. Sovremennaya Revmatologiya. 2015;(1):4–23. (In Russ.) https://doi.org/10.14412/1996-7012-2015-1-4-23.Laine L. Approaches to nonsteroidal anti-inflammatory drug use in the high-risk patient. Gastroenterology. 2001;120(3):594–606. https://doi.org/10.1053/gast.2001.21907.Laine L. Approaches to nonsteroidal anti-inflammatory drug use in the high-risk patient. Gastroenterology. 2001;120(3):594–606. https://doi.org/10.1053/gast.2001.21907.Dawood M.Y. Primary dysmenorrhea: advances in pathogenesis and management. Obstet Gynecol. 2006;108(2):428–441. https://doi.org/10.1097/01.AOG.0000230214.26638.0c.Dawood M.Y. Primary dysmenorrhea: advances in pathogenesis and management. Obstet Gynecol. 2006;108(2):428–441. https://doi.org/10.1097/01.AOG.0000230214.26638.0c.Wang R., Bathon J.M., Ward M.M. Nonsteroidal Antiinflammatory Drugs as Potential Disease-Modifying Medications in Axial Spondyloarthritis. Arthritis Rheumatol. 2020;72(4):518–528. https://doi.org/10.1002/art.41164.Wang R., Bathon J.M., Ward M.M. Nonsteroidal Antiinflammatory Drugs as Potential Disease-Modifying Medications in Axial Spondyloarthritis. Arthritis Rheumatol. 2020;72(4):518–528. https://doi.org/10.1002/art.41164.Shekelle P.G., Newberry S.J., FitzGerald J.D., Motala A., O’Hanlon C.E., Tariq A. et al. Management of Gout: A Systematic Review in Support of an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166(1):37–51. https://doi.org/10.7326/M16-0461.Shekelle P.G., Newberry S.J., FitzGerald J.D., Motala A., O’Hanlon C.E., Tariq A. et al. Management of Gout: A Systematic Review in Support of an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166(1):37–51. https://doi.org/10.7326/M16-0461.Oyler D.R., Parli S.E., Bernard A.C., Chang P.K., Procter L.D., Harned M.E. Nonopioid management of acute pain associated with trauma: Focus on pharmacologic options. J Trauma Acute Care Surg. 2015;79(3):475–483. https://doi.org/10.1097/TA.0000000000000755.Oyler D.R., Parli S.E., Bernard A.C., Chang P.K., Procter L.D., Harned M.E. Nonopioid management of acute pain associated with trauma: Focus on pharmacologic options. J Trauma Acute Care Surg. 2015;79(3):475–483. https://doi.org/10.1097/TA.0000000000000755.Vellani V., Moschetti G., Franchi S., Giacomoni C., Sacerdote P., Amodeo G. Effects of NSAIDs on the Release of Calcitonin Gene-Related Peptide and Prostaglandin E2 from Rat Trigeminal Ganglia. Mediators Inflamm. 2017;2017:9547056. https://doi.org/10.1155/2017/9547056.Vellani V., Moschetti G., Franchi S., Giacomoni C., Sacerdote P., Amodeo G. Effects of NSAIDs on the Release of Calcitonin Gene-Related Peptide and Prostaglandin E2 from Rat Trigeminal Ganglia. Mediators Inflamm. 2017;2017:9547056. https://doi.org/10.1155/2017/9547056.Hing E., Hall M.J., Ashman J.J., Xu J. National Hospital Ambulatory Medical Care Survey: 2007 Outpatient Department Summary. Natl Health Stat Report. 2010;(28):1–32. Available at: https://pubmed.ncbi.nlm.nih.gov/20942378.Hing E., Hall M.J., Ashman J.J., Xu J. National Hospital Ambulatory Medical Care Survey: 2007 Outpatient Department Summary. Natl Health Stat Report. 2010;(28):1–32. Available at: https://pubmed.ncbi.nlm.nih.gov/20942378.Musu M., Finco G., Antonucci R., Polati E., Sanna D.,Evangelista M. et al. Acute nephrotoxicity of NSAID from the foetus to the adult. Eur Rev Med Pharmacol Sci. 2011;15(12):1461–1472. Available at: https://pubmed.ncbi.nlm.nih.gov/22288307.Musu M., Finco G., Antonucci R., Polati E., Sanna D.,Evangelista M. et al. Acute nephrotoxicity of NSAID from the foetus to the adult. Eur Rev Med Pharmacol Sci. 2011;15(12):1461–1472. Available at: https://pubmed.ncbi.nlm.nih.gov/22288307.Pai A. Keeping kidneys safe: the pharmacist’s role in NSAID avoidance in high-risk patients. J Am Pharm Assoc (2003). 2015;55(1):e15–е25. https://doi.org/10.1331/JAPhA.2015.15506.Pai A. Keeping kidneys safe: the pharmacist’s role in NSAID avoidance in high-risk patients. J Am Pharm Assoc (2003). 2015;55(1):e15–е25. https://doi.org/10.1331/JAPhA.2015.15506.Davis A., Registrar G. The dangers of NSAIDs: look both ways. Br J Gen Pract. 2016;66(645):172–173. https://doi.org/10.3399/bjgp16X684433.Davis A., Registrar G. The dangers of NSAIDs: look both ways. Br J Gen Pract. 2016;66(645):172–173. https://doi.org/10.3399/bjgp16X684433.Ghlichloo I., Gerriets V. Nonsteroidal Anti-inflammatory Drugs (NSAIDs). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. Available at: https://www.ncbi.nlm.nih.gov/books/NBK547742.Ghlichloo I., Gerriets V. Nonsteroidal Anti-inflammatory Drugs (NSAIDs). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. Available at: https://www.ncbi.nlm.nih.gov/books/NBK547742.Sostres C., Gargallo C.J., Arroyo M.T., Lanas A. Adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs, aspirin and coxibs) on upper gastrointestinal tract. Best Pract Res Clin Gastroenterol. 2010;24(2):121–132. https://doi.org/10.1016/j.bpg.2009.11.005.Sostres C., Gargallo C.J., Arroyo M.T., Lanas A. Adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs, aspirin and coxibs) on upper gastrointestinal tract. Best Pract Res Clin Gastroenterol. 2010;24(2):121–132. https://doi.org/10.1016/j.bpg.2009.11.005.Kasciuškevičiūtė S., Gumbrevičius G., Vendzelytė A., Ščiupokas A., Petrikonis K., Kaduševičius E. Impact of the World Health Organization Pain Treatment Guidelines and the European Medicines Agency Safety Recommendations on Nonsteroidal Anti-Inflammatory Drug Use in Lithuania: An Observational Study. Medicina (Kaunas). 2018;54(2):30. https://doi.org/10.3390/medicina54020030.Kasciuškevičiūtė S., Gumbrevičius G., Vendzelytė A., Ščiupokas A., Petrikonis K., Kaduševičius E. Impact of the World Health Organization Pain Treatment Guidelines and the European Medicines Agency Safety Recommendations on Nonsteroidal Anti-Inflammatory Drug Use in Lithuania: An Observational Study. Medicina (Kaunas). 2018;54(2):30. https://doi.org/10.3390/medicina54020030.Rothenberg R.J., Holcomb J.P.Jr. Guidelines for Monitoring of NSAIDS: Who Listened? J Clin Rheumatol. 2000;6(5):258–265. https://doi.org/10.1097/00124743-200010000-00005.Rothenberg R.J., Holcomb J.P.Jr. Guidelines for Monitoring of NSAIDS: Who Listened? J Clin Rheumatol. 2000;6(5):258–265. https://doi.org/10.1097/00124743-200010000-00005.Thomas D., Ali Z., Zachariah S., Sundararaj K.G.S., Van Cuyk M., Cooper J.C. Coxibs Refocus Attention on the Cardiovascular Risks of Non-Aspirin NSAIDs. Am J Cardiovasc Drugs. 2017;17(5):343–346. https://doi.org/10.1007/s40256-017-0223-6.Thomas D., Ali Z., Zachariah S., Sundararaj K.G.S., Van Cuyk M., Cooper J.C. Coxibs Refocus Attention on the Cardiovascular Risks of Non-Aspirin NSAIDs. Am J Cardiovasc Drugs. 2017;17(5):343–346. https://doi.org/10.1007/s40256-017-0223-6.Harirforoosh S., Asghar W., Jamali F. Adverse effects of nonsteroidal antiinflammatory drugs: an update of gastrointestinal, cardiovascular and renal complications. J Pharm Pharm Sci. 2013;16(5):821–847. https://doi.org/10.18433/j3vw2f.Harirforoosh S., Asghar W., Jamali F. Adverse effects of nonsteroidal antiinflammatory drugs: an update of gastrointestinal, cardiovascular and renal complications. J Pharm Pharm Sci. 2013;16(5):821–847. https://doi.org/10.18433/j3vw2f.Talley N.J., Evans J.M., Fleming K.C., Harmsen W.S., Zinsmeister A.R., Melton L.J. Nonsteroidal antiinflammatory drugs and dyspepsia in the elderly. Dig Dis Sci. 2005;40(6):1345–1350. https://doi.org/10.1007/BF02065549.Talley N.J., Evans J.M., Fleming K.C., Harmsen W.S., Zinsmeister A.R., Melton L.J. Nonsteroidal antiinflammatory drugs and dyspepsia in the elderly. Dig Dis Sci. 2005;40(6):1345–1350. https://doi.org/10.1007/BF02065549.Low E.X.S., Zheng Q., Chan E., Lim S.G. Drug induced liver injury: East versus West – a systematic review and meta-analysis. Clin Mol Hepatol. 2020;26(2):142–154. https://doi.org/10.3350/cmh.2019.1003.Low E.X.S., Zheng Q., Chan E., Lim S.G. Drug induced liver injury: East versus West – a systematic review and meta-analysis. Clin Mol Hepatol. 2020;26(2):142–154. https://doi.org/10.3350/cmh.2019.1003.Sriuttha P., Sirichanchuen B., Permsuwan U. Hepatotoxicity of Nonsteroidal Anti-Inflammatory Drugs: A Systematic Review of Randomized Controlled Trials. Int J Hepatol. 2018;2018:5253623. https://doi.org/10.1155/2018/5253623.Sriuttha P., Sirichanchuen B., Permsuwan U. Hepatotoxicity of Nonsteroidal Anti-Inflammatory Drugs: A Systematic Review of Randomized Controlled Trials. Int J Hepatol. 2018;2018:5253623. https://doi.org/10.1155/2018/5253623.Pereira C.M.C., Júnior G.J.D., Lima J.V.D.N., Alves Lemos S.I., da Rocha Rodrigues L., Dos Santos Ferreira J. et al. Phosphatidylinositol 3-kinase gamma participates in nimesulide-induced hepatic damage. J Pharm Pharmacol. 2021;73(4):496–504. https://doi.org/10.1093/jpp/rgaa049.Pereira C.M.C., Júnior G.J.D., Lima J.V.D.N., Alves Lemos S.I., da Rocha Rodrigues L., Dos Santos Ferreira J. et al. Phosphatidylinositol 3-kinase gamma participates in nimesulide-induced hepatic damage. J Pharm Pharmacol. 2021;73(4):496–504. https://doi.org/10.1093/jpp/rgaa049.Kwon J., Kim S., Yoo H., Lee E. Nimesulide-induced hepatotoxicity: A systematic review and meta-analysis. PLoS ONE. 2019;14(1):e0209264. https://doi.org/10.1371/journal.pone.0209264.Kwon J., Kim S., Yoo H., Lee E. Nimesulide-induced hepatotoxicity: A systematic review and meta-analysis. PLoS ONE. 2019;14(1):e0209264. https://doi.org/10.1371/journal.pone.0209264.Bessone F., Hernandez N., Mendizabal M., Ridruejo T., Gualano G., Fassio E. et al. Serious liver injury induced by Nimesulide: an international collaborative study. Arch Toxicol. 2021;95(4):1475–1487. https://doi.org/10.1007/s00204-021-03000-8.Bessone F., Hernandez N., Mendizabal M., Ridruejo T., Gualano G., Fassio E. et al. Serious liver injury induced by Nimesulide: an international collaborative study. Arch Toxicol. 2021;95(4):1475–1487. https://doi.org/10.1007/s00204-021-03000-8.Whelton A. Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic foundations and clinical implications. Am J Med. 1999;106(5B):13S–24S. https://doi.org/10.1016/s0002-9343(99)00113-8.Whelton A. Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic foundations and clinical implications. Am J Med. 1999;106(5B):13S–24S. https://doi.org/10.1016/s0002-9343(99)00113-8.Xu Y., Li W., Han Y., Liu H., Zhang S., Yan J. et al. Regulatory effects of non-steroidal anti-inflammatory drugs on cardiac ion channels Nav1.5 and Kv11.1. Chem Biol Interact. 2021;338:109425. https://doi.org/10.1016/j.cbi.2021.109425.Xu Y., Li W., Han Y., Liu H., Zhang S., Yan J. et al. Regulatory effects of non-steroidal anti-inflammatory drugs on cardiac ion channels Nav1.5 and Kv11.1. Chem Biol Interact. 2021;338:109425. https://doi.org/10.1016/j.cbi.2021.109425.Rotunno R., Oppo I., Saetta G., Aveta P., Bruno S. NSAIDs and heart failure: A dangerous relationship. Monaldi Arch Chest Dis. 2018;88(2):950. https://doi.org/10.4081/monaldi.2018.950.Rotunno R., Oppo I., Saetta G., Aveta P., Bruno S. NSAIDs and heart failure: A dangerous relationship. Monaldi Arch Chest Dis. 2018;88(2):950. https://doi.org/10.4081/monaldi.2018.950.Schink T., Kollhorst B., Varas C., Arfe A., Herings R., Lucchi S. et al. Risk of ischemic stroke and the use of individual non-steroidal anti-inflammatory drugs: A multi-country European database study within the SOS Project. PLoS ONE. 2018;13(9):e0203362. https://doi.org/10.1371/journal.pone.0203362.Schink T., Kollhorst B., Varas C., Arfe A., Herings R., Lucchi S. et al. Risk of ischemic stroke and the use of individual non-steroidal anti-inflammatory drugs: A multi-country European database study within the SOS Project. PLoS ONE. 2018;13(9):e0203362. https://doi.org/10.1371/journal.pone.0203362.Schafer A.I. Effects of nonsteroidal anti-inflammatory therapy on platelets. Am J Med. 1999;106(5B):25S–36S. https://doi.org/10.1016/s0002-9343(99)00114-x.Schafer A.I. Effects of nonsteroidal anti-inflammatory therapy on platelets. Am J Med. 1999;106(5B):25S–36S. https://doi.org/10.1016/s0002-9343(99)00114-x.Berkes E.A. Anaphylactic and anaphylactoid reactions to aspirin and other NSAIDs. Clin Rev Allergy Immunol. 2003;24(2):137–148. https://doi.org/10.1385/CRIAI:24:2:137.Berkes E.A. Anaphylactic and anaphylactoid reactions to aspirin and other NSAIDs. Clin Rev Allergy Immunol. 2003;24(2):137–148. https://doi.org/10.1385/CRIAI:24:2:137.Terzioğlu K., Sancar Ö., Ekerbiçer H.Ç., Öztürk R.T., Epöztürk K. Tolerability to paracetamol and preferential COX-2 inhibitors in patients with cross-reactive nonsteroidal anti-inflammatory drugs hypersensitivity. Asia Pac Allergy. 2020;10(3):e29. https://doi.org/10.5415/apallergy.2020.10.e29.Terzioğlu K., Sancar Ö., Ekerbiçer H.Ç., Öztürk R.T., Epöztürk K. Tolerability to paracetamol and preferential COX-2 inhibitors in patients with cross-reactive nonsteroidal anti-inflammatory drugs hypersensitivity. Asia Pac Allergy. 2020;10(3):e29. https://doi.org/10.5415/apallergy.2020.10.e29.Szczeklik A. Adverse reactions to aspirin and nonsteroidal anti-inflammatory drugs. Ann Allergy. 1987;59(5):113–118. Available at: https://pubmed.ncbi.nlm.nih.gov/3318575/.Szczeklik A. Adverse reactions to aspirin and nonsteroidal anti-inflammatory drugs. Ann Allergy. 1987;59(5):113–118. Available at: https://pubmed.ncbi.nlm.nih.gov/3318575/.Cantarutti A., Franchi M., Rea F., Merlino L., Corrao G. Use of Nimesulide During Early Pregnancy and the Risk of Congenital Malformations: A Population-Based Study from Italy. Adv Ther. 2018;35(7):981–992. https://doi.org/10.1007/s12325-018-0735-8.Cantarutti A., Franchi M., Rea F., Merlino L., Corrao G. Use of Nimesulide During Early Pregnancy and the Risk of Congenital Malformations: A Population-Based Study from Italy. Adv Ther. 2018;35(7):981–992. https://doi.org/10.1007/s12325-018-0735-8.Bronstein A.C., Spyker D.A., Cantilena L.R. Jr, Green J.L., Rumack B.H., Giffin S.L. 2009 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 27th Annual Report. Clin Toxicol (Phila). 2010;48(10):979–1178. https://doi.org/10.3109/15563650.2010.543906.Bronstein A.C., Spyker D.A., Cantilena L.R. Jr, Green J.L., Rumack B.H., Giffin S.L. 2009 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 27th Annual Report. Clin Toxicol (Phila). 2010;48(10):979–1178. https://doi.org/10.3109/15563650.2010.543906.Van der Hooft C.S., Dieleman J.P., Siemes C., Aarnoudse A.-J., Verhamme K., Stricker B., Sturkenboom M. Adverse drug reaction-related hospitalisations: a population-based cohort study. Pharmacoepidemiol Drug Saf. 2008;17(4):365–371. https://doi.org/10.1002/pds.1565.Van der Hooft C.S., Dieleman J.P., Siemes C., Aarnoudse A.-J., Verhamme K., Stricker B., Sturkenboom M. Adverse drug reaction-related hospitalisations: a population-based cohort study. Pharmacoepidemiol Drug Saf. 2008;17(4):365–371. https://doi.org/10.1002/pds.1565.Дядык А.И., Куглер Т.Е. Побочные эффекты нестероидных противовоспалительных препаратов. Consilium Medicum. 2017;(12):94–99. Режим доступа: https://journals.eco-vector.com/2075-1753/article/view/94951.Dyadyk A.I., Kugler T.E. Side effects of nonsteroidal anti-inflammatory drugs. Consilium Medicum. 2017;(12):94–99. (In Russ.) Available at: https://journals.eco-vector.com/2075-1753/article/view/94951.Парфенов В.А., Яхно Н.Н., Давыдов О.С., Кукушкин М.Л., Чурюканов М.В., Головачева В.А. и др. Хроническая неспецифическая (скелетно-мышечная) поясничная боль. Рекомендации Российского общества по изучению боли (РОИБ). Неврология, нейропсихиатрия, психосоматика. 2019;(S1):7–16. https://doi.org/10.14412/2074-2711-2019-2S-7-16.Parfenov V.A., Yakhno N.N., Davydov O.S., Kukushkin M.L., Churyukanov M.V., Golovacheva V.A. et al. Chronic nonspecific (musculoskeletal) low back pain. Guidelines of the Russian Society for the Study of Pain (RSSP). Neurology, Neuropsychiatry, Psychosomatics. 2019;(S1):7–16. (In Russ.) https://doi.org/10.14412/2074-2711-2019-2S-7-16.Агасаров Л.Г., Кузьмина И.В., Чигарев А.А., Марьяновский А.А. Клиника, патогенез и коррекция проявлений дорсопатий. Вестник новых медицинских технологий. 2015;(1):1–6. Режим доступа: https://vnmt.ru/Bulletin/E2015-1/5071.pdf.Agasarov L.G., Kuzmina I.V., Chigarev A.A., Marianovsky A.A. Clinical manifestations, pathogenesis and correction of dorsopathies. Journal of New Medical Technologies. 2015;(1):1–6. (In Russ.) Available at: https://vnmt.ru/Bulletin/E2015-1/5071.pdf.Самарцев И.Н., Живолупов С.А., Нажмудинов Р.З., Яковлев Е.В. Исследование КАМЕЛИЯ: сравнительная оценка безопасности и эффективности кратковременного применения ацеклофенака и мелоксикама у пациентов с вертеброгенными дорсалгиями. Эффективная фармакотерапия. 2018;(20):38–49. Режим доступа: https://umedp.ru/upload/iblock/b50/Aertal.pdf.Samartsev I.N., Zhivolupov S.A., Nazhmudinov R.Z., Yakovlev E.V. Study CAMELLIA: Comparative evaluation of safety and efficacy of aceclofenac and meloxicam short-term use in patients with vertebrogenic dorsalgia. Effective Pharmacotherapy. 2018;(20):38–49. (In Russ.) Available at: https://umedp.ru/upload/iblock/b50/Aertal.pdf.Ветрова Т.В. Роль техники прикладной релаксации в проведении комплексной психологической коррекции тревожности. В: Психофизиологические и медико-социальные аспекты прикладных научных исследований. СПб.; 2022. 42 с. Режим доступа: https://www.elibrary.ru/item.asp?id=48724065.Vetrova T.V. The role of applied relaxation techniques in the complex psychological correction of anxiety. In: Psychophysiological and medico-social aspects of applied scientific research. St Petersburg; 2022. 42 р. (In Russ.) Available at: https://www.elibrary.ru/item.asp?id=48724065.

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