spbmedicalrecordsНовые Санкт-Петербургские врачебные ведомостиNew St. Petersburg Medical Records1609-2201Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова10.24884/1609-2201-2026-105-1-44-54spbmedicalrecords-125Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSПерсонализированный подход к выбору прямого орального антикоагулянта для различных групп населения: расовая принадлежность, функция почек, лекарственные взаимодействия и фармакогенетикаPersonalized approach to the selection of direct oral anticoagulant for different population groups: race, kidney function, drug interactions and pharmacogeneticshttps://orcid.org/0000-0001-6284-7133КасимоваА. Р.KasimovaA. R.

Касимова Алина Рашидовна, кандидат медицинских наук, доцент, доцент кафедры клинической фармакологии и доказательной медицины; врач-клинический фармаколог, отделения клинической фармакологии

197022, Санкт-Петербург, ул. Льва Толстого, д. 6‒8

Alina R. Kasimova, Cand. of Sci. (Med.), associate professor of the department of Clinical Pharmacology and Evidence-Based Medicine; Clinical pharmacologist of the Department of Clinical Pharmacology

 

kasi-alina@yandex.ruhttps://orcid.org/0000-0003-3449-8196БорисовА. М.BorisovA. M.

Борисов Алексей Михайлович, врач-клинический фармаколог, отделения клинической фармакологии

Санкт-Петербург

Alexey М. Borisov, Clinical pharmacologist of the Department of Clinical Pharmacology

Saint Petersburg

laennec1@yandex.ruhttps://orcid.org/0000-0002-1919-2909КолбинА. С.KolbinA. S.

Колбин Алексей Сергеевич, доктор медицинских наук, профессор, заведующий кафедрой клинической фармакологии и доказательной медицины

Санкт-Петербург

Alexey S. Kolbin, Dr. of Sci. (Med.), Professor, Head of Chair of Clinical Pharmacology and Evidence-Based Medicine

Saint Petersburg

alex.kolbin@mail.ruПервый Санкт-Петербургский государственный университет им. акад. И. П. Павлова; Национальный медицинский исследовательский центр травматологии и ортопедии имени Р.Р. ВреденаРоссияPavlov University; National Medical Research Center of Traumatology and orthopedics named after R. R. VredenRussian FederationНациональный медицинский исследовательский центр травматологии и ортопедии имени Р.Р. ВреденаРоссияNational Medical Research Center of Traumatology and orthopedics named after R. R. VredenRussian FederationПервый Санкт-Петербургский государственный университет им. акад. И. П. Павлова; Санкт-Петербургский государственный университетРоссияPavlov University; Saint Petersburg State UniversityRussian Federation202608072026014454Copyright © Касимова А.Р., Борисов А.М., Колбин А.С., 20262026Касимова А.Р., Борисов А.М., Колбин А.С.Kasimova A.R., Borisov A.M., Kolbin A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.docved.ru/jour/article/view/125

В обзоре представлена хронология разработки и внедрения в клиническую практику прямых пероральных антикоагулянтов (ПОАК) — дабигатрана, ривароксабана, апиксабана и эдоксабана.

Подробно проанализированы фармакокинетические различия препаратов (биодоступность, период полувыведения, почечный клиренс, лекарственные взаимодействия), а также влияние возраста, пола, массы тела и генетических факторов на вариабельность ответа. Предложен пошаговый алгоритм выбора антикоагулянта, учитывающий абсолютные показания к варфарину (механические клапаны, антифосфолипидный синдром, тяжелая хроническая болезнь почек), противопоказания для ПОАК и клинические особенности их применения.

На основании открытых литературных источников определено место и условия для применения варфарина в современной клинической практике, несмотря на все более широкое применение ПОАК.

The review presents the chronology of the development and introduction into clinical practice of direct oral anticoagulants (POAC) — dabigatran, rivaroxaban, apixaban and edoxaban.

The pharmacokinetic differences of drugs (bioavailability, half-life, renal clearance, drug interactions), as well as the influence of age, gender, body weight, and genetic factors on response variability were analyzed in detail. A step-by-step algorithm for choosing an anticoagulant is proposed, taking into account the absolute indications for warfarin (mechanical valves, antiphospholipid syndrome, severe chronic kidney disease), contraindications for OAC and the clinical features of their use..

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