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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="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">tbjournal</journal-id><journal-title-group><journal-title xml:lang="ru">Туберкулез и социально значимые заболевания</journal-title><trans-title-group xml:lang="en"><trans-title>Tuberculosis and socially significant diseases</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2413-0346</issn><issn pub-type="epub">2413-0354</issn><publisher><publisher-name>ООО «Ин-Тренд</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.54921/2413-0346-2024-12-4-54-65</article-id><article-id custom-type="elpub" pub-id-type="custom">tbjournal-568</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>ОБЗОР ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LITERATURE REVIEW</subject></subj-group></article-categories><title-group><article-title>Терапевтический лекарственный мониторинг в лечении больных туберкулезом</article-title><trans-title-group xml:lang="en"><trans-title>Therapeutic drug monitoring in the treatment of tuberculosis patients</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>Иванова</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ivanova</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Иванова Диана Александровна – ученый секретарь, врач-фтизиатр, врач-терапевт Городского клинико-диагностического центра; профессор кафедры фтизиатрии; доктор медицинских наук</p><p>107014, г. Москва, ул. Стромынка, д. 10, стр. 1</p><p>Тел.: +7 (499) 269-14-10</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">d-ivanova@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Литвинова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Litvinova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Литвинова Наталья Витальевна – ведущий научный сотрудник научно-клинического отдела; кандидат медицинских наук</p><p>107014, г. Москва, ул. Стромынка, д. 10, стр. 1</p><p>Тел.: +7 (499) 269-14-10</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">natali.litwinowa2015@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Юровская</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Yurovskaya</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Юровская Екатерина Игоревна – врач-фтизиатр диспансерного фтизиатрического отделения филиала по СЗАО</p><p>123182, г. Москва, ул. Щукинская, д. 38</p><p>Тел.: +7 (499) 190-04-11</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">dr.the_end_tb@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кубракова</surname><given-names>Е. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Kubrakova</surname><given-names>E. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кубракова Елена Петровна – заведующая туберкулезным легочным отделением филиала по СЗАО</p><p>123182, г. Москва, ул. Щукинская, д. 38</p><p>Тел.: +7 (499) 190-04-11</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">docepk75@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Митрофанова</surname><given-names>Ю. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Mitrofanova</surname><given-names>Yu. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Митрофанова Юлия Юрьевна – редактор отдела эпидемиологического мониторинга туберкулеза</p><p>107014, г. Москва, ул. Стромынка, д. 10, стр. 1</p><p>Тел.: +7 (499) 269-14-10</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">yuyumit@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБУЗ «Московский городской научно-практический центр борьбы с туберкулезом Департамента&#13;
здравоохранения города Москвы»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава&#13;
России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health; Federal State-Funded Educational Institution of Continuing Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ГБУЗ «Московский городской научно-практический центр борьбы с туберкулезом Департамента&#13;
здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>02</day><month>03</month><year>2025</year></pub-date><volume>12</volume><issue>4</issue><fpage>54</fpage><lpage>65</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Иванова Д.А., Литвинова Н.В., Юровская Е.И., Кубракова Е.П., Митрофанова Ю.Ю., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Иванова Д.А., Литвинова Н.В., Юровская Е.И., Кубракова Е.П., Митрофанова Ю.Ю.</copyright-holder><copyright-holder xml:lang="en">Ivanova D.A., Litvinova N.V., Yurovskaya E.I., Kubrakova E.P., Mitrofanova Y.Y.</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.tb-journal.ru/jour/article/view/568">https://www.tb-journal.ru/jour/article/view/568</self-uri><abstract><p>Терапевтический лекарственный мониторинг (ТЛМ) является одной из наиболее перспективных технологий персонализированной терапии туберкулеза, способных значительно улучшить эффективность и безопасность лечения у самых сложных категорий больных. Прикладная цель ТЛМ – оптимизация доз противотуберкулезных препаратов на основе контроля их сывороточных концентраций в процессе лечения.</p><p>В обзоре рассмотрены основные принципы, определения и параметры ТЛМ, современные показания к тестированию, методики сбора, анализа и интерпретации данных с позиций практикующего фтизиатра; представлен анализ доказательной базы. Целевыми популяциями для внедрения ТЛМ являются больные с ВИЧ-инфекцией, сахарным диабетом, другой тяжелой поликоморбидной патологией; пациенты детского и пожилого возраста с замедленным ответом на лечение и высоким риском тяжелых нежелательных реакций.</p><p>Для эффективного внедрения ТЛМ необходимо проведение контролируемых исследований по оценке его клинических и экономических результатов, разработка методик, позволяющих увеличить доступность этой технологии для максимального числа противотуберкулезных учреждений.</p></abstract><trans-abstract xml:lang="en"><p>Therapeutic drug monitoring (TDM) is one of the most promising technologies for personalized tuberculosis therapy, which can significantly improve the efficacy and safety of treatment in the most complex categories of patients. The applied goal of TDM is to optimize doses of TB drugs based on the control of their serum concentrations during treatment.</p><p>The review considers the basic principles, definitions and parameters of TLM, current indications for testing, methods of data collection, analysis and interpretation from the perspective of a practicing phthisiatric physician; analysis of the evidence base is presented. The target populations for implementation of TLM are patients with HIV infection, diabetes mellitus, other severe multicomorbid pathology; pediatric and elderly patients, with delayed response to treatment and high risk of severe adverse reactions.</p><p>For effective implementation of TLM it is necessary to conduct controlled studies to assess its clinical and economic results, to develop methods to increase the availability of this technology for the maximum number of TB institutions.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>терапевтический лекарственный мониторинг</kwd><kwd>лечение туберкулеза</kwd><kwd>фармакокинетика противотуберкулезных препаратов</kwd><kwd>особые ситуации</kwd><kwd>персонализированный подход</kwd></kwd-group><kwd-group xml:lang="en"><kwd>therapeutic drug monitoring</kwd><kwd>tuberculosis treatment</kwd><kwd>pharmacokinetics of TB drugs</kwd><kwd>special situations</kwd><kwd>personalized approach</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">Абаимов Д.А., Сариев А.К., Носкова Т.Ю. и др. 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