rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2019-15-3-359-367rpcardio-1958Research ArticleASSOCIATED PROBLEMS OF CARDIOLOGYСМЕЖНЫЕ ВОПРОСЫ КАРДИОЛОГИИAtherosclerosis and Osteoporosis. Common Targets for the Effects of Cardiovascular and Anti-Osteoporotic Drugs (Part II). The Effect of Antiosteoporotic Drugs on the Vascular Wall StateАтеросклероз и остеопороз. Общие мишени для влияния сердечно-сосудистых и антиостеопорозных препаратов (Часть II). Влияние антиостеопорозных препаратов на состояние сосудистой стенкиСкрипниковаИ. А.SkripnikovaI. A.

д.м.н., руководитель отдела профилактики остеопороза

Россия, 101990, Москва, Петроверигский пер., 10

MD, PhD., Head of Osteoporosis Prevention Department

Petroverigsky per. 10, Moscow, 101990 Russia

ISkripnikova@gnicpm.ruКосматоваО. В.KosmatovaO. V.

к.м.н., с.н.с., отдел профилактики остеопороза

Россия, 101990, Москва, Петроверигский пер., 10

MD, PhD, Senior Researcher, Osteoporosis Prevention Department

Petroverigsky per. 10, Moscow, 101990 Russia

КолчинаМ. А.KolchinаM. A.

врач, консультативное отделение

Россия, 101990, Москва, Петроверигский пер., 10

MD, Doctor, Advisory Department

Petroverigsky per. 10, Moscow, 101990 Russia

МягковаМ. А.MyagkovaM. A.

н.с., отдел профилактики остеопороза

Россия, 101990, Москва, Петроверигский пер., 10

MD, Researcher, Osteoporosis Prevention Department

Petroverigsky per. 10, Moscow, 101990 Russia

АлихановаН. А.AlikhanovaN. A.

к.м.н., м.н.с., отдел профилактики остеопороза

Россия, 101990, Москва, Петроверигский пер., 10

PhD, Junior Researcher, Osteoporosis Prevention Department

Petroverigsky per. 10, Moscow, 101990 Russia

Национальный медицинский исследовательский центр профилактической медициныРоссияNational Medical Research Center for Preventive MedicineRussian Federation201902072019153359367Copyright © Skripnikova I.A., Kosmatova O.V., Kolchinа M.A., Myagkova M.A., Alikhanova N.A., 20192019Скрипникова И.А., Косматова О.В., Колчина М.А., Мягкова М.А., Алиханова Н.А.Skripnikova I.A., Kosmatova O.V., Kolchinа M.A., Myagkova M.A., Alikhanova N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/1958

In the second part of the literature review, data are presented on the possible effect of anti-osteoporosis therapy on the vascular wall and the development of calcification. The discovery of common biological substances involved in the development of atherosclerosis, calcification of the vascular wall and osteoporosis attracts the attention of scientists in terms of targets for assessing the effects of already known drugs or developing new drugs that can simultaneously prevent or slow the progression of both atherosclerosis and osteoporosis. Currently, various groups of drugs for the treatment of osteoporosis have been studied to prevent or reduce the progression of subclinical atherosclerosis and calcification. Both antiresorptive drugs (bisphosphonates, monoclonal antibodies to RANKL, selective estrogen receptor modulators), and bone-anabolic therapy, which includes teriparatide, were studied. However, there are a few such studies and the most promising drugs that have a preventive effect in the early stages of atherosclerotic damage are bisphosphonates. Other classes of antiosteoporotic drugs did not reveal a positive effect on the vascular wall, and some of them increased the cardiovascular risk. Divergences in the results of experimental and clinical studies attract attention. If in the experiment almost all drugs for the treatment of osteoporosis had an atheroprotective effect and suppressed vascular calcification, then in clinical conditions only bisphosphonates confirmed the positive effect on the vascular wall.

Во второй части обзора литературы приводятся данные о возможном влиянии антиостеопорозной терапии на сосудистую стенку и развитие кальцификации. Открытие общих биологических веществ, участвующих в развитии атеросклероза, кальцификации сосудистой стенки и остеопороза привлекает внимание ученых с точки зрения мишеней для оценки эффектов уже известных препаратов или разработки новых лекарственных средств, способных одновременно предотвратить развитие или замедлить прогрессирование как атеросклероза, так и остеопороза. В настоящее время различные группы препаратов для лечения остеопороза исследованы с целью предотвращения или снижения прогрессирования субклинического атеросклероза и сосудистой кальцификации. Изучались как антирезорбтивные препараты (бисфосфонаты, моноклональные антитела к RANKL, селективные модуляторы эстрогенных рецепторов), так и костно-анаболическая терапия, к которой относится терипаратид. Однако таких исследований немного, и наиболее перспективными препаратами, оказывающими профилактический эффект на ранних стадиях атеросклеротического повреждения, являются бисфосфонаты. У других классов антиостеопорозных препаратов не было выявлено позитивного влияния на сосудистую стенку, а некоторые из них повышали сердечно-сосудистый риск. Обращают на себя внимание расхождения в результатах экспериментальных и клинических исследований. Если в эксперименте практически все препараты для лечения остеопороза оказывали атеропротективный эффект и подавляли сосудистую кальцификацию, то в клинических условиях только бисфосфонаты подтвердили позитивное влияние на сосудистую стенку.

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