Materials of the expert council on the topic “Morpholinium thiosate: From mechanisms of action to clinical practice. Optimization of clinical application”

The publication presents the findings of a multidisciplinary expert council convened to analyze data from clinical studies on morpholinium thiazotate (thiotriazoline) conducted with a focus on cardiovascular and liver disease, as well as their comorbidities. Thiotriazoline’s mechanism of action is based on its ability to mitigate oxidative stress by modulating NO synthase activity, improve endothelial function, and exert anti-inflammatory effects. Clinical studies have demonstrated its efficacy in treating cardiovascular diseases, liver disorders, and their combined presentations. Of particular interest is its potential as an adjunct therapy in oncology and phthisiopulmonology where cardiotoxicity and hepatotoxicity pose significant challenges. The expert council evaluated the available research and outlined key recommendations for thiotriazoline’s clinical use and further investigation. The drug can be recommended as either a primary or adjunctive therapy for: cardiovascular diseases (stable angina pectoris II– III functional class, chronic heart failure, drug-induced cardiotoxicity); combined liver and cardiovascular disorders, including non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease, and metabolic dysfunctionassociated liver injury (MET-ABP); reducing cardioand hepatotoxicity in oncology and antituberculosis treatмent. To strengthen the evidence base, further methodologically rigorous clinical trials are needed.

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