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<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="en"><front><journal-meta><journal-id journal-id-type="publisher-id">rpcardio</journal-id><journal-title-group><journal-title xml:lang="en">Rational Pharmacotherapy in Cardiology</journal-title><trans-title-group xml:lang="ru"><trans-title>Рациональная Фармакотерапия в Кардиологии</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1819-6446</issn><issn pub-type="epub">2225-3653</issn><publisher><publisher-name>«SILICEA-POLIGRAF» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20996/1819-6446-2020-10-17</article-id><article-id custom-type="elpub" pub-id-type="custom">rpcardio-2316</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="en"><subject>CURRENT QUESTIONS OF CLINICAL PHARMACOLOGY</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>АКТУАЛЬНЫЕ  ВОПРОСЫ  КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИ</subject></subj-group></article-categories><title-group><article-title>Pharmacokinetics and Pharmacogenetics of Apixaban</article-title><trans-title-group xml:lang="ru"><trans-title>Фармакокинетика и фармакогенетика апиксабана</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>Савинова</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Savinova</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Савинова Алина Валерьевна – ординатор, отделение персонализированной психиатрии и неврологии</p><p>192019, Санкт-Петербург, ул. Бехтерева, 3 </p></bio><bio xml:lang="en"><p>Alina V. Savinova – MD, Resident</p><p>Bekhtereva ul. 3, St.-Petersburg, 192019</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>Петрова</surname><given-names>М. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Petrova</surname><given-names>M. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Петрова Марина Михайловна – доктор медицинских наук, профессор, заведующий кафедрой поликлинической терапии и семейной медицины с курсом последипломного образования; врач-кардиолог, Профессорская клиника</p><p>660022, Красноярск, ул. Партизана Железняка, 1 </p></bio><bio xml:lang="en"><p>Marina M. Petrova – MD, PhD, Professor, Head of Chair of Outpatient Therapy and General Practice with Course of Postgraduate Education; Cardiologist of the Professor’s Clinic</p><p>Zheleznyaka ul. 1, Krasnoyarsk, 660022 </p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шнайдер</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shnayder</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шнайдер Наталья Алексеевна – доктор медицинских наук, профессор, ведущий научный сотрудник, отделение персонализированной психиатрии и неврологии, НМИЦ ПН им. В.М. Бехтерева; ведущий научный сотрудник, центр коллективного пользования «Молекулярные и клеточные технологии», КрасГМУ им. проф. В.Ф. Войно-Ясенецкого</p><p>192019, Санкт-Петербург, ул. Бехтерева, 3, </p><p>660022, Красноярск, ул. Партизана Железняка, 1 </p></bio><bio xml:lang="en"><p>Natalia A. Shnayder – MD, PhD, Professor, Leading Researcher, Department of Personalized Psychiatry and Neurology, Bekhterev National Medical Research Center of Psychiatry and Neurology; Leading Researcher, Center of Collective Usage “Molecular and Cellular Technologies”, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky</p><p>Bekhtereva ul. 3, St.-Petersburg, 192019, </p><p>Zheleznyaka ul. 1, Krasnoyarsk, 660022 </p></bio><email xlink:type="simple">naschnaider@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бочанова</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Bochanova</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бочанова Елена Николаевна – доктор медицинских наук, доцент, кафедра фармакологии и фармацевтического консультирования с курсом последипломного образования</p><p>660022, Красноярск, ул. Партизана Железняка, 1 </p></bio><bio xml:lang="en"><p>Elena N. Bochanova – MD, PhD, Associate Professor, Chair of Pharmacology and Pharmaceutical Consulting with Course of Postgraduate Education</p><p>Zheleznyaka ul. 1, Krasnoyarsk, 660022 </p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Насырова</surname><given-names>Р. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Nasyrova</surname><given-names>R. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Насырова Регина Фаритовна – доктор медицинских наук, главный научный сотрудник, руководитель отделения персонализированной психиатрии и неврологии, НМИЦ ПН им. В.М. Бехтерева; главный научный сотрудник, научно-исследовательская лаборатория OpenLab «Генные и клеточные технологии», Институт фундаментальной медицины и биологии, Казанский федеральный университет</p><p>192019, Санкт-Петербург, ул. Бехтерева, 3, </p><p>420008, Казань, ул. Кремлевская, 18 </p></bio><bio xml:lang="en"><p>Regina F. Nasyrova – MD, PhD, Cheif Researcher, Head of Department of Personalized Psychiatry and Neurology, Bekhterev National Medical Research Center of Psychiatry and Neurology; Chief Researcher, Research Laboratory OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University</p><p>Bekhtereva ul. 3, St.-Petersburg, 192019, </p><p>Kremlyovskaya ul. 18, Kazan, 420008</p></bio><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Bekhterev National Medical Research Center of Psychiatry and Neurology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky Partizana</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева;&#13;
Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Bekhterev National Medical Research Center of Psychiatry and Neurology;&#13;
Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky Partizana</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева;&#13;
Казанский федеральный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Bekhterev National Medical Research Center of Psychiatry and Neurology;&#13;
Kazan Federal University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>04</day><month>11</month><year>2020</year></pub-date><volume>16</volume><issue>5</issue><fpage>852</fpage><lpage>860</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Savinova A.V., Petrova M.M., Shnayder N.A., Bochanova E.N., Nasyrova R.F., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Савинова А.В., Петрова М.М., Шнайдер Н.А., Бочанова Е.Н., Насырова Р.Ф.</copyright-holder><copyright-holder xml:lang="en">Savinova A.V., Petrova M.M., Shnayder N.A., Bochanova E.N., Nasyrova R.F.</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.rpcardio.online/jour/article/view/2316">https://www.rpcardio.online/jour/article/view/2316</self-uri><abstract><p>Apixaban is oral anticoagulant, it is widely used in prevention of stroke in non-valvular atrial fibrillation and treatment of deep vein thrombosis and pulmonary embolism. Its main mechanism of action is through reversible inhibition of factor Xa. It specifically binds and inhibits both free and bound factor Xa which ultimately results in reduction in the levels of thrombin formation. Apixaban is mainly metabolized by CYP3A4 with minor contributions from CYP1A2, CYP2C8, CYP2C9, CYP2C19 and CYP2J2 isoenzymes. Some of the major metabolic pathways of apixaban include o-demethylation, hydroxylation, and sulfation, with o-demethylapixabansulphate being the major metabolite. The aim of this review is analysis of associated researches of single nucleotide variants (SNV) of CYP3A5 and SULT1A1 genes and search for new candidate genes reflecting effectiveness and safety of apixaban. The search for full-text publications in Russian and English languages containing key words “apixaban”, “pharmacokinetics”, “effectiveness”, “safety” was carried out amongst literature of the past twenty years with the use of eLibrary, PubMed, Web of Science, OMIM data bases. Pharmacokinetics and pharmacogenetics of apixaban are considered in this review. The hypothesis about CYP и SULT1A enzymes influence on apixaban metabolism was examined. To date, numerous SNVs of the CYP3A5 and SULT1A1 genes have been identified, but their potential influence on pharmacokinetics apixaban in clinical practice needs to be further studies. The role of SNVs of other genes encoding beta-oxidation enzymes of apixaban (CYP1A2, CYP2C8, CYP2C9, CYP2C19, CYP2J2) and transporter proteins (ABCB1, ABCG2) in its efficacy and safety are not well understood, and ABCB1 and ABCG2 genes may be potential candidate genes for studies of the drug safety.</p></abstract><trans-abstract xml:lang="ru"><p>Апиксабан – оральный антикоагулянт, широко используемый для профилактики инсульта при неклапанной фибрилляции предсердий, лечения тромбоза глубоких вен и тромбоэмболии легочной артерии. Его основной механизм действия – обратимое ингибирование фактора Ха. Апиксабан специфически связывает и ингибирует как свободный, так и связанный фактор Ха, что в конечном итоге приводит к снижению образования тромбина. Апиксабан в основном метаболизируется CYP3A5 с незначительным участием изоферментов CYP1A2, CYP2C8, CYP2C9, CYP2C19 и CYP2J2. Некоторые из основных метаболических путей апиксабана включают о-деметилирование, гидроксилирование и сульфатирование, при этом о-деметилапиксабан сульфат является основным метаболитом. Целью данного обзора является анализ ассоциативных исследований однонуклеотидных вариантов (ОНВ) генов CYP3A5 и SULT1A1, а также поиск новых генов-кандидатов, отражающих эффективность и безопасность применения апиксабана. Проведен поиск полнотекстовых публикаций на русском и английском языках за последние два десятилетия в базах данных eLibrary, PubMed, Web of Science, OMIM, используя ключевые слова: «апиксабан», «фармакокинетика», «фармакогенетика», «эффективность», «безопасность». Подробно рассмотрена фармакокинетика апиксабана, а также фармакогенетические особенности метаболизма данного препарата. Обсуждается гипотеза о влиянии ферментов семейства CYP и SULT1A на метаболизм апиксабана. К настоящему времени идентифицированы многочисленные ОНВ генов CYP3A5 и SULT1A1, но их потенциальное влияние на фармакокинетику апиксабана в реальной клинической практике нуждается в дальнейшем исследовании. Роль ОНВ других генов, кодирующих ферменты бета-окисления апиксабана (CYP1A2, CYP2C8, CYP2C9, CYP2C19, CYP2J2) и белков-транспортеров (ABCB1, ABCG2) в его эффективности и безопасности недостаточно изучена, однако гены ABCB1 и ABCG2 могут являться потенциальными генами-кандидатами для исследования безопасности применения препарата.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>апиксабан</kwd><kwd>фармакокинетика</kwd><kwd>фармакогенетика</kwd><kwd>эффективность</kwd><kwd>безопасность</kwd><kwd>CYP3A5</kwd><kwd>SULT1A1</kwd><kwd>ABCB1</kwd><kwd>ABCG2</kwd></kwd-group><kwd-group xml:lang="en"><kwd>apixaban</kwd><kwd>pharmacokinetics</kwd><kwd>pharmacogenetics</kwd><kwd>effectiveness</kwd><kwd>safety</kwd><kwd>CYP3A5</kwd><kwd>SULT1A1</kwd><kwd>ABCB1</kwd><kwd>ABCG2</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">Bristol-Myers Squibb. 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