<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<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="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">russjcardiol</journal-id><journal-title-group><journal-title xml:lang="ru">Российский кардиологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Cardiology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1560-4071</issn><issn pub-type="epub">2618-7620</issn><publisher><publisher-name>«SILICEA-POLIGRAF» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15829/1560-4071-2018-4-75-81</article-id><article-id custom-type="elpub" pub-id-type="custom">russjcardiol-2793</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>КЛИНИКА И ФАРМАКОТЕРАПИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>GUIDELINES FOR THE PRACTITIONER</subject></subj-group></article-categories><title-group><article-title>СРАВНЕНИЕ ВЛИЯНИЯ НА АГРЕГАЦИЮ ТРОМБОЦИТОВ ОРИГИНАЛЬНОГО ПРЕПАРАТА (ПЛАВИКС)  И ЕГО ДЖЕНЕРИКА (КЛАПИТАКС): РЕЗУЛЬТАТЫ НАБЛЮДАТЕЛЬНОГО ИССЛЕДОВАНИЯ</article-title><trans-title-group xml:lang="en"><trans-title>COMPARISON OF THE ORIGINAL (PLAVIx) AND GENERIC (CLAPITAx) CLOPIDOGREL ON PLATELET  AGGREGATION: ObSERVATIONAL STUDY</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>Скотников</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Skotnikov</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат  медицинских наук.</p><p> </p></bio><bio xml:lang="en"><p>Moscow.</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>Сизова</surname><given-names>Ж. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Sizova</surname><given-names>Zh. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д. м.н., профессор.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</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>Багликов</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Baglikov</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат  медицинских наук.</p><p>Калуга.</p></bio><bio xml:lang="en"><p>Kaluga.</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рожнова</surname><given-names>О. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Rozhnova</surname><given-names>O. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Новицкий</surname><given-names>Н. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Novitsky</surname><given-names>N. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач.</p><p>Калуга.</p></bio><bio xml:lang="en"><p>Kaluga.</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И. М. Сеченова Минздрава РФ; АНО Научно-исследовательский центр коморбидной патологии “Рациональная медицина”.</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University of the Ministry of Health; Scientific-Research Center of Comorbid Pathology “Rational Medicine”.</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И. М. Сеченова Минздрава РФ.</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University of the Ministry of Health/</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ГБУЗ Калужской области Городская клиническая больница № 2 “Сосновая роща”.</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kaluzhskaya Oblast City Clinical Hospital № 2 “Pine Grove”.</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>АНО Научно-исследовательский центр коморбидной патологии “Рациональная медицина”.</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Scientific-Research Center of Comorbid Pathology “Rational Medicine”.</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>09</day><month>05</month><year>2018</year></pub-date><volume>0</volume><issue>4</issue><fpage>75</fpage><lpage>81</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Скотников А.С., Сизова Ж.М., Багликов А.Н., Рожнова О.Г., Новицкий Н.И., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Скотников А.С., Сизова Ж.М., Багликов А.Н., Рожнова О.Г., Новицкий Н.И.</copyright-holder><copyright-holder xml:lang="en">Skotnikov A.S., Sizova Z.M., Baglikov A.N., Rozhnova O.G., Novitsky N.I.</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://russjcardiol.elpub.ru/jour/article/view/2793">https://russjcardiol.elpub.ru/jour/article/view/2793</self-uri><abstract><sec><title>Цель</title><p>Цель.  Сравнить антитромбоцитарную активность оригинального клопидогрела и его дженерика, а также изучить рутинную практику приёма антитромбоцитарных препаратов пациентами со стабильными проявлениями атеросклероза.</p></sec><sec><title>Материал и методы</title><p> Материал и методы. Общее число наблюдаемых пациентов, ранее получающих клопидогрел, составило 186 человек, из которых 54 человека амбулаторно длительно принимали оригинальный клопидогрел, а остальные 132 пациента — его дженерики. Аденозиндифосфат индуцированная активность тромбоцитов определялась в двух группах пациентов (n=57) принимавших поочередно Плавикс и Клапитакс до замены препарата и через 14 дней после замены.</p></sec><sec><title>Результаты</title><p>Результаты. При смене препаратов в группе 1 (Клапитакс→Плавикс) и группе 2 (Плавикс→Клапитакс) уровень достигнутого эффекта сохранялся, а в группе 2 характеризовался дополнительным статистически не значимым снижением. Нежелательных явлений, связанных с проведением антиагрегантной терапии не выявлено. На стационарном этапе в терапии 117 больных авторами была зафиксирована замена (в т. ч. неоднократная) оригинального клопидогрела на его различные дженерики (n=65), и наоборот (n=52), что было связано с рядом рутинных причин, среди которых пожелания пациентов и их родственников, особенности лекарственного обеспечения лечебно-профилактического учреждения, на базе которого проводилась неинтервенционная программа.</p></sec><sec><title>Заключение</title><p>Заключение. Установленная одинаковая остаточная реактивность тромбоцитов после приема Клапитакса и Плавикса в двух группах свидетельствует об их терапевтической эквивалентности.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Aim</title><p>Aim. To compare antiplatelet activeness of the original clopidogrel and its generic, and to evaluate the routine practice of antiplatelet drugs intake by clinically stable patients aiming prevention of atherothrombosis.</p></sec><sec><title>Material and methods</title><p>Material and methods. Total number of patients that have been taking clopidogrel: 186, of those at outpatient stage 54 on original clopidogrel, the rest 132 on generic. Adenosindiphosphate-induced activeness was measured in two groups (n=57) taking consequently Plavix and Clapitax before replacement of the drug and 14 days after.</p></sec><sec><title>Results</title><p>Results. At interchange of the drug in group 1 (Clapitax to Plavix) and group 2 (Plavix to Clapitax) the grade of achieved effect remained, and in group 2 it showed additional non-significant decrease. Adverse events related to antiplatelet therapy were not registered. At in-patient stage, 117 patients had an interchange of the drug (incl. several times) of original clopidogrel to its various generics (n=65), and vice versa (n=52), that was related to a range of routine reasons, of those patient and relatives preferences, specifics of drug supply in a clinic.</p></sec><sec><title>Conclusion</title><p>Conclusion. The found equal residual reactivity of the platelets after Clapitax and Plavix intake in two groups witness on therapeutical equivalence of the drugs.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>антиагреганты</kwd><kwd>терапевтическая эквивалентность</kwd><kwd>клопидогрел</kwd><kwd>Клапитакс</kwd><kwd>Плавикс</kwd></kwd-group><kwd-group xml:lang="en"><kwd>antiplatelets</kwd><kwd>therapeutical equivalence</kwd><kwd>clopidogrel</kwd><kwd>Clapitax</kwd><kwd>Plavix</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">Yusuf S, Mehta SR, Zhao F, et al. on Behalf of the CURE (Clopidogrel in Unstable angina to prevent Recurrent Events) Trial Investigators. Early and Late Effects of Clopidogrel in Patients With Acute Coronary Syndromes. Circulation. 2003; 107: 966-72. DOI: 10.1161/01.CIR.0000051362.96946.15.</mixed-citation><mixed-citation xml:lang="en">Yusuf S, Mehta SR, Zhao F, et al. on Behalf of the CURE (Clopidogrel in Unstable angina to prevent Recurrent Events) Trial Investigators. Early and Late Effects of Clopidogrel in Patients With Acute Coronary Syndromes. Circulation. 2003; 107: 966-72. DOI: 10.1161/01.CIR.0000051362.96946.15.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Eisenstein EL, Anstrom KJ, Kong DF, et al. Clopidogrel use and long-term clinical outcomes after drug-eluting stent implantation. JAMA. 2006 Dec 5: E1-E10.</mixed-citation><mixed-citation xml:lang="en">Eisenstein EL, Anstrom KJ, Kong DF, et al. Clopidogrel use and long-term clinical outcomes after drug-eluting stent implantation. JAMA. 2006 Dec 5: E1-E10.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Clopidogrel in Unstable angina to prevent Recurrent Events trial (CURE) investigators. Effects of dopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N. Engl.J.Med. 2001; 345: 494-8.</mixed-citation><mixed-citation xml:lang="en">Clopidogrel in Unstable angina to prevent Recurrent Events trial (CURE) investigators. Effects of dopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N. Engl.J.Med. 2001; 345: 494-8.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Price MJ, Angiolillo DJ, Teirstein PS, et al. Platelet reactivity and cardiovascular outcomes after percutaneous coronary interventions. A time-dependent analysis of the Gauging Responsiveness with a Verify Now P2Y12 Assay: Impact on Thrombosis and Safety (GRAVITAS) trial. 2011 Sep 6; 124 (10):1132-7. DOI: 10.1161/CIRCULATIONAHA.111.029165.</mixed-citation><mixed-citation xml:lang="en">Price MJ, Angiolillo DJ, Teirstein PS, et al. Platelet reactivity and cardiovascular outcomes after percutaneous coronary interventions. A time-dependent analysis of the Gauging Responsiveness with a Verify Now P2Y12 Assay: Impact on Thrombosis and Safety (GRAVITAS) trial. 2011 Sep 6; 124 (10):1132-7. DOI: 10.1161/CIRCULATIONAHA.111.029165.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology. Guidelines for the diagnosis and treatment of non-ST segment elevation acute coronary syndromes. Eur Heart J 2007; 28: 1598-660. DOI: 10.1093/eurheartj/ehm161.</mixed-citation><mixed-citation xml:lang="en">The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology. Guidelines for the diagnosis and treatment of non-ST segment elevation acute coronary syndromes. Eur Heart J 2007; 28: 1598-660. DOI: 10.1093/eurheartj/ehm161.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Palmerini T, Barozzi C, Tomasi L, et al. A randomised study comparing the antiplatelet and antiinflammatory effect of clopidogrel 150 mg/day versus 75 mg/day in patients with ST– segment elevation acute myocardial infarction and poor responsiveness to clopidogrel: results from the DOUBLE study. Thromb Res. 2010; 125 (4): 309-14. DOI: 10.1016/j. thromres.2009.06.016.</mixed-citation><mixed-citation xml:lang="en">Palmerini T, Barozzi C, Tomasi L, et al. A randomised study comparing the antiplatelet and antiinflammatory effect of clopidogrel 150 mg/day versus 75 mg/day in patients with ST– segment elevation acute myocardial infarction and poor responsiveness to clopidogrel: results from the DOUBLE study. Thromb Res. 2010; 125 (4): 309-14. DOI: 10.1016/j. thromres.2009.06.016.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Cannon CP, Harrington RA, James S, et al. Comparison of ticagrelor with clopidogrel in patients with a planned invasive strategy for acute coronary syndromes (PLATO): a randomised double-blind study. Lancet. 2010; 375 (9711): 283-93. DOI: 10.1016/S0140-6736(09)62191-7.</mixed-citation><mixed-citation xml:lang="en">Cannon CP, Harrington RA, James S, et al. Comparison of ticagrelor with clopidogrel in patients with a planned invasive strategy for acute coronary syndromes (PLATO):  a randomised double-blind study. Lancet. 2010; 375 (9711): 283-93. DOI: 10.1016/S0140-6736(09)62191-7.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Held C, Asenblad N, Bassand JP, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes undergoing coronary artery bypass surgery: results from the PLATO (Platelet Inhibition and Patient Outcomes) trial. J. Am. Coll. Cardiol. 2011; 57(6):672-84. DOI: 10.1016/j.jacc.2010.10.029.</mixed-citation><mixed-citation xml:lang="en">Held C, Asenblad N, Bassand JP, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes undergoing coronary artery bypass surgery: results from the PLATO (Platelet Inhibition and Patient Outcomes) trial. J. Am. Coll. Cardiol. 2011; 57(6):672-84. DOI: 10.1016/j.jacc.2010.10.029.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">James SK, Roe MT, Cannon CP, et al. PLATO Study Group. Ticagrelor versus clopidogrel in patients with acute coronary syndromes intended for non-invasive management: substudy from prospective e randomized PLATelet inhibition and patient Outcomes (PLATO) trial. BMJ. 2011; 342: d3527. DOI: 10.1136/bmj.d3527.</mixed-citation><mixed-citation xml:lang="en">James SK, Roe MT, Cannon CP, et al. PLATO Study Group. Ticagrelor versus clopidogrel in patients with acute coronary syndromes intended for non-invasive management: substudy from prospective e randomized PLATelet inhibition and patient Outcomes (PLATO) trial. BMJ. 2011; 342: d3527. DOI: 10.1136/bmj.d3527.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Lindholm D, Varenhorst C, Cannon CP et al. Ticagrelor vs. clopidogrel in patients with nonST-elevation acute coronary syndrome with or without revascularization: results from the PLATO trial. Eur.Heart J. 2014; 35 (31): 2083-93. DOI: 10.1093/eurheartj/ehu160.</mixed-citation><mixed-citation xml:lang="en">Lindholm D, Varenhorst C, Cannon CP et al. Ticagrelor vs. clopidogrel in patients with nonST-elevation acute coronary syndrome with or without revascularization: results from the PLATO trial. Eur.Heart J. 2014; 35 (31): 2083-93. DOI: 10.1093/eurheartj/ehu160.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Montalescot G, van’t Hof AW, Lapostolle F, et al. ATLANTIC Investigators. Prehospital ticagrelor in ST-elevation myocardial infarction. N. Engl. J. Med. 2014; 371: 1016-27.</mixed-citation><mixed-citation xml:lang="en">Montalescot G, van’t Hof AW, Lapostolle F, et al. ATLANTIC Investigators. Prehospital ticagrelor in ST-elevation myocardial infarction. N. Engl. J. Med. 2014; 371: 1016-27.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Tavlueva EV, Yarkovskaya AP, Penskaya TY, et al. Hypoaggregatory effect in patients with myocardial infarction with an elevation of the ST segment with the replacement of clopidogrel with ticagrelor. Atherothrombosis. 2016; 2: 54-60. (In Russ.) Тавлуева Е. В., Ярковская А. П., Алексеенко А. В., и др. Гипоагрегационный эффект у больных инфарктом миокарда с подъёмом сегмента ST при замене клопидогрела на тикагрелор. Атеротромбоз, 2016; 2: 54-60. DOI: 10.21518/2307-1109-2016-2-54-60.</mixed-citation><mixed-citation xml:lang="en">Tavlueva EV, Yarkovskaya AP, Penskaya TY, et al. Hypoaggregatory effect in patients with myocardial infarction with an elevation of the ST segment with the replacement of clopidogrel with ticagrelor. Atherothrombosis. 2016; 2: 54-60. (In Russ.) Тавлуева Е. В., Ярковская А. П., Алексеенко А. В., и др. Гипоагрегационный эффект у больных инфарктом миокарда с подъёмом сегмента ST при замене клопидогрела на тикагрелор. Атеротромбоз, 2016; 2: 54-60. DOI: 10.21518/2307-1109-2016-2-54-60.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
