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<article article-type="review-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/ms2024-157</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-8267</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>САХАРНЫЙ ДИАБЕТ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>DIABETES MELLITUS</subject></subj-group></article-categories><title-group><article-title>Комбинация пиоглитазона и алоглиптина в управлении сахарным диабетом 2-го типа: высокая сахароснижающая и кардиометаболическая эффективность</article-title><trans-title-group xml:lang="en"><trans-title>Collaboration of alogliptin and pioglitazone: a double hit on the target</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1851-0941</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Салухов</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Salukhov</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Салухов Владимир Владимирович, д.м.н., профессор, начальник 1-й кафедры (терапии усовершенствования врачей)</p><p>194044, Санкт-Петербург, ул. Академика Лебедева, д. 6</p></bio><bio xml:lang="en"><p>Vladimir V. Salukhov, Dr. Sci. (Med.), Associate Professor, Head of the 1st Department (Advanced Therapy for Doctors)</p><p>6, Akademik Lebedev St., St Petersburg, 194044</p></bio><email xlink:type="simple">vlasaluk@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3784-8473</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ковалевская</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kovalevskaya</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ковалевская Елена Александровна, к.м.н., старший преподаватель 1-й кафедры (терапии усовершенствования врачей)</p><p>194044, Санкт-Петербург, ул. Академика Лебедева, д. 6</p></bio><bio xml:lang="en"><p>Elena A. Kovalevskaya, Cand. Sci. (Med.), Senior Lecturer of the 1st Department (Advanced Therapy for Doctors)</p><p>6, Akademik Lebedev St., St Petersburg, 194044</p></bio><email xlink:type="simple">fili-elena@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7961-4755</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ильинская</surname><given-names>T. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ilyinskaya</surname><given-names>Т. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ильинская Татьяна Александровна, к.м.н., преподаватель 1-й кафедры (терапии усовершенствования врачей)</p><p>194044, Санкт-Петербург, ул. Академика Лебедева, д. 6</p></bio><bio xml:lang="en"><p>Tatyana A. Ilinskaya, Cand. Sci. (Med.), Lecturer of the 1st Department (Advanced Therapy for Doctors)</p><p>6, Akademik Lebedev St., St Petersburg, 194044</p></bio><email xlink:type="simple">tany120982@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Военно-медицинская академия имени С.М. Кирова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Military Medical Academy named after S.M. Kirov</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>18</day><month>05</month><year>2024</year></pub-date><volume>0</volume><issue>6</issue><fpage>24</fpage><lpage>35</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Салухов В.В., Ковалевская Е.А., Ильинская T.А., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Салухов В.В., Ковалевская Е.А., Ильинская T.А.</copyright-holder><copyright-holder xml:lang="en">Salukhov V.V., Kovalevskaya E.A., Ilyinskaya Т.A.</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/8267">https://www.med-sovet.pro/jour/article/view/8267</self-uri><abstract><p>Сахарный диабет – это не только проблема гипергликемии, но и ассоциация с тяжелыми сердечно-сосудистыми заболеваниями и фатальными исходами. В настоящее время сахароснижающие препараты рассматриваются не только как эффективные глюкозоредуцирующие средства, но и как кардиобезопасные или даже как кардиопротективные агенты. Фиксированные комбинации сахароснижающих препаратов различных групп с сочетанными механизмами фармакологического воздействия на уровень гликемии оказываются эффективней, чем монотерапия. Реинкарнация тиазолидиндионов внесла свою лепту в создание различных вариантов этих комбинаций. Изучение плейотропных эффектов пиоглитазона в виде влияния на ремоделирование миокарда, а также выявленные антифибротические и антиатеросклеротические свойства открыли новые возможности для применения этого препарата как в монотерапии, так и в сочетании с другими сахароснижающими агентами. В свою очередь, антиатеросклеротические свойства алоглиптина доказаны в различных исследованиях. В результате комбинация «пиоглитазон/алоглиптин» показала достоверно большее сахароснижающее действие, чем отдельное применение данных препаратов, наряду с доказанным кардиопротективным эффектом, низким риском гипогликемии, улучшением функции поджелудочной железы и отсутствием увеличения побочных эффектов. Несмотря на фармакологическое различие этих препаратов (в виде разного начала действия), в итоге сочетание «пиоглитазон/алоглиптин» с фармакодинамической точки зрения показывает более высокую эффективность, чем каждый препарат в отдельности, в виде улучшения ремоделирования миокарда, снижения формирование фиброза, замедления развития атеросклероза, снижения активности хронического воспаления. Сочетание двух препаратов в одной таблетке повышает приверженность пациентов к лечению, что позволяет с большей долей вероятности достичь целевые показатели гликемии и предотвратить неблагоприятные сердечно-сосудистые исходы.</p></abstract><trans-abstract xml:lang="en"><p>Diabetes mellitus is not only a problem of hyperglycemia, but is also associated with severe cardiovascular disease and fatal outcomes. Currently, glucose-lowering drugs are considered not only as effective glucose-reducing agents, but also as cardiosafe or even cardioprotective agents. Fixed combinations of glucose-lowering drugs of various groups with combined mechanisms of pharmacological effects on glycemic levels are more effective than monotherapy. The reincarnation of thiazolidinediones has contributed to the creation of various variants of these combinations. The study of the pleiotropic effects of pioglitazone in the form of an effect on myocardial remodeling, as well as the identified antifibrotic and antiatherosclerotic properties, has opened up new opportunities for the use of this drug both in monotherapy and in combination with other hypoglycemic agents. In turn, the antiatherosclerotic properties of alogliptin have been proven in various studies. As a result, the combination of “pioglitazone/alogliptin” showed a significantly greater hypoglycemic effect than the individual use of these drugs, along with a proven cardioprotective effect, a low risk of hypoglycemia, improved pancreatic function and no increase in side effects. Despite the pharmacological differences between these drugs (in the form of different onset of action), in the end the combination of “pioglitazone/alogliptin” from a pharmacodynamic point of view shows higher effectiveness than each drug separately in the form of improved myocardial remodeling, reduced formation of fibrosis, slowed down the development of atherosclerosis, reduced activity of chronic inflammation. The combination of two drugs in one tablet improves patient adherence to treatment, making it more likely to achieve glycemic goals and prevent adverse cardiovascular outcomes.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>тиазолидиндионы</kwd><kwd>ингибиторы ДПП-4</kwd><kwd>сердечно-сосудистые исходы</kwd><kwd>атеросклероз</kwd><kwd>липиды</kwd></kwd-group><kwd-group xml:lang="en"><kwd>thiazolidinediones</kwd><kwd>DPP-4 inhibitors</kwd><kwd>cardiovascular outcomes</kwd><kwd>atherosclerosis</kwd><kwd>lipids</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">Богданова ЕА, Шустов СБ, Свистов АС, Кицышин ВП. Особенности ишемии миокарда у больных сахарным диабетом 2-го типа в сочетании с ишемической болезнью сердца по данным суточного мониторирования электрокардиограммы. Вестник Российской Военно-медицинской академии. 2012;(1):44. 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