Russian Drug Research Articles

Resolution of the scientific and practical conference «Decisions of expert councils on the clinical use of the Russian drug product Relatox in neurological practice in adults and children»

Resolution of the scientific and practical conference «Decisions of expert councils on the clinical use of the Russian drug product Relatox in neurological practice in adults and children»

Post hoc analysis of the results of KOLIBRI comparative observational clinical study in patients with knee and small hand joints osteoarthritis

Objective: to evaluate the effectiveness of therapy with AMBENE®Bio (AB) in comparison with the comparator drug (bioactive concentrate of small marine fish, BCSMF) in patients with osteoarthritis (OA) of large and small joints in routine clinical practice.Patients and methods. KOLIBRI multicenter, observational, non-randomized, comparative study included 233 patients with OA of the small hand joints (HJ) or knee joints (KJ) from three Russian centers (two in Moscow and one in Tula). Patients with a generalized form of OA were excluded from the analysis. The remaining patients were divided into two groups depending on the localization of OA. The first group included 174 patients with knee OA, 105 of them received AB, and 69 received the reference drug (BCSMF) according to the same regimen. The second group consisted of 21 women with HJ OA: 13 patients were prescribed AB, and 8 — the reference drug.The duration of the study averaged 330±14 days, the total number of visits was 4. The main indicator of effectiveness was the dynamics of pain during movement according to VAS (0—100 mm) 30±7 days after the start of treatment compared with the baseline value. All patients underwent radiography of the HJ and KJ, as well as ultrasound of the involved joints.Results and discussion. Both drugs provided significant clinical improvement in patients with OA, which is consistent with other studies with similar design and long follow-up. These data confirm the symptom-modifying properties of the presented group of combined drugs in the OA treatment. The Russian injectable drug AB in OA was not inferior in effectiveness to the foreign BCSMF. According to the OMERACT-OARSI criteria, 85.2% and 88.9% of patients, respectively, responded to treatment with AB and the reference drug. In both groups, half of the patients managed to stop further use of non-steroidal anti-inflammatory drugs (NSAIDs) on a regular basis.Conclusion. The use of AB was accompanied not only by a decrease in the severity of clinical symptoms of OA, but also by a decrease in the daily requirement for NSAIDs almost by 2 times.

Interleukin 6 receptor inhibitors in the treatment of rheumatoid arthritis during the COVID-19 pandemic, Moscow experience

Objective: to confirm the efficacy and safety of levilimab in patients with rheumatoid arthritis (RA) switched from other interleukin 6 receptor inhibitors (iIL6R) for non-medical reasons.Patients and methods. A retrospective analysis of data from the register of patients with RA who during the COVID-19 pandemic were switched from foreign iIL6Rs to the Russian drug levilimab. Treatment regimens with levilimab in combination with synthetic diseasemodifying antirheumatic drugs (sDMARDs) and/or glucocorticoids (GCs) were used, as well as a monotherapy regimen in case of DMARDs intolerance.Results and discussion. In 150 patients with RA, a successful non-medical switch to levilimab was demonstrated with the preservation and intensification of the clinical effect achieved on previous therapy with iIL6R. After switching to levilimab, the DAS28-CRP index decreased by an average of 0.098 at 3 months and by 0.25 at 6 months (p=0.214 for both time points). There was a decrease in the proportion of patients with elevated levels of CRP, as well as with high RA activity. In a number of patients who showed high efficacy of levilimab, it became possible to reduce the dose or number of DMARDs, as well as cease GCs intake. Good tolerability and a favorable safety profile of levilimab were noted, including in relation to the new coronavirus infection that developed during therapy.Conclusion. Therapy with Russian iIL6R levilimab is effective and safe, including in patients switched from other drugs for non-medical reasons, as well as in relation to the novel coronavirus infection that developed during therapy.

Adverse Drug Reaction Concept Normalization in Russian-Language Reviews of Internet Users

Mapping the pharmaceutically significant entities on natural language to standardized terms/concepts is a key task in the development of the systems for pharmacovigilance, marketing, and using drugs out of the application scope. This work estimates the accuracy of mapping adverse reaction mentions to the concepts from the Medical Dictionary of Regulatory Activity (MedDRA) in the case of adverse reactions extracted from the reviews on the use of pharmaceutical products by Russian-speaking Internet users (normalization task). The solution we propose is based on a neural network approach using two neural network models: the first one for encoding concepts, and the second one for encoding mentions. Both models are pre-trained language models, but the second one is additionally tuned for the normalization task using both the Russian Drug Reviews (RDRS) corpus and a set of open English-language corpora automatically translated into Russian. Additional tuning of the model during the proposed procedure increases the accuracy of mentions of adverse drug reactions by 3% on the RDRS corpus. The resulting accuracy for the adverse reaction mentions mapping to the preferred terms of MedDRA in RDRS is 70.9% F1-micro. The paper analyzes the factors that affect the accuracy of solving the task based on a comparison of the RDRS and the CSIRO Adverse Drug Event Corpus (CADEC) corpora. It is shown that the composition of the concepts of the MedDRA and the number of examples for each concept play a key role in the task solution. The proposed model shows a comparable accuracy of 87.5% F1-micro on a subsample of RDRS and CADEC datasets with the same set of MedDRA preferred terms.

Safety of Mexidol® (ethylmethylhydroxypyridine succinate) in adult patients of different age groups

To reduce the risk of developing adverse events (AEs) and increase the adherence of elderly patients to treatment, it is recommended to limit maximally the total number of prescribed drugs (DR), using one drug for the treatment of two or more pathologies if possible. The drugs that meet the criteria for use in elderly patients and / or patients with comorbidity include the original Russian drug Mexidol® (ethylmethylhydroxypyridine succinate), which has a multimodal mechanism of action and has multiple pharmacological effects. In order to study the safety of Mexidol in comparison with placebo in different age groups of patients with chronic cerebral ischemia, a post hoc analysis of the international multicenter, randomized, double-blind, placebo-controlled MEMO study with an adaptive design was carried out, which assessed the efficacy and safety of sequential therapy with Mexidol®, a solution for intravenous and intramuscular injection, 50 mg/ml (NPK PHARMASOFT, Russia) and Mexidol® FORTE 250 film-coated tablets, 250 mg (NPK PHARMASOFT, Russia) in patients with chronic cerebral ischemia. The study involved 318 patients aged from 40 to 90 years.Comparable safety and tolerability of Mexidol was demonstrated in middle-aged and elderly people with chronic cerebral ischemia, including patients over 75 years of age.

Prospects for the use of osteobiotics in antibiotic therapy

The recent trend towards the frequent prescription of antibiotics has indicated the need for additional therapy to offset the harm done to the body in general and to the musculo skeletal system in particular. This review examines the specifics and effects of the new class of drugs called osteobiotics. The efficacy of the first Russian drug of this category and the possibility of its use in antibiotic therapy are evaluated.

Hypoactive sexual desire disorders in women: ways to solve the problem

In recent decades, women are increasingly contact the doctors with problems of hypoactive sexual desire disorders (HSDD). Female libido is considered as one of the important indicators of quality of life, sexual health. Therapy of HSDD is difficult due to insufficient knowledge by doctors of both complex, multiple pathogenetic mechanisms of libido reduction and modern therapeutic approaches. In this article, the female sexual desire is considered from the point of view of the biopsychosocial approach, recognized as the leading one when working with sexual dysfunctions. According to biopsychosocial approach, HSDD is a consequence of combined disorders at various levels of human functioning (somatic, personal-psychological and individual-social). Modern conceptual models of sexual desire are presented, on the basis of which therapeutic approaches to HSDD are developed. The most effective from the evidence point of view directions of therapy of HSDD in women – elimination of biomedical factors that violate libido, psychotherapeutic measures (sexual awareness, cognitive behavioral therapy, sexual therapy) are discussed. Evidence-based studies confirming the high effectiveness of an integrative approach to the therapy of HSDD, combining sexual awareness, CBT, sexual therapy and pharmacotherapy, are presented. A new Russian drug – a peptide created specifically for the treatment of HSDD in women is presented. The drug has passed all stages of clinical trials and can be used both in the treatment of idiopathic HSDD and as part of combine therapy (in combination with psychotherapy and sextherapy).

Dimethyloxobutylphosphonyl dimethylate (dimephosphone). Pharmacological effects. Neurotropic and cerebroprotective properties

Dimethyloxobutylphosphonyl dimethylate (dimephosphone) is a Russian drug of metabolic action, developed in Kazan in 1952 at the Institute of Organic and Physical Chemistry named after A. E. Arbuzov, Kazan Branch of the Academy of Sciences of the USSR, and at the Department of Pharmacology, Kazan State Medical University. Its novelty and originality are confirmed by patents in many countries. [2] The paper presents a review of the literature, which confirms that dimephosphone is able to restore damaged brain structures, improves cerebral circulation, and has neurotropic and cerebroprotective properties.

Treatment of osteoporosis in clinical practice: first experience with the Russian generic drug of zoledronic acid

Objective: to evaluate the effect of the generic drug of zoledronic acid on bone mineral density (BMD) and markers of bone metabolism in patients with osteoporosis (OP), as well as possible long-term adverse reactions (AR) 12 months after drug administration.Patients and methods. The study included 30 postmenopausal women with OP (mean age 64±8 years) who signed an informed consent of participance in clinical observation. Patients received a single dose of generic zoledronic acid (5 mg) as a 15-minute infusion. All patients additionally took calcium and vitamin D. The dynamics of BMD and bone metabolism markers, as well as the safety and tolerability of the drug, were evaluated. Fractures that might have occurred during follow-up should have been reported as ARs.Results and discussion. During treatment with generic zoledronic acid, the increase in BMD in the lumbar region was 4.9% (p<0.0001), in the femoral neck –2.7% (p<0.01), and in the femur as a whole – 3.0% (p<0.0001). Positive dynamics (increase in BMD>2%) in the spine was detected in 26 (86.7%) patients, in the proximal femur – in 20 (66.7%) patients. There was a decrease in the intensity of pain in both the thoracic (by 62%; p=0.038) and lumbar (by 29%; p=0.022) spine. Three months after the administration of the drug, a decrease in the level of bone metabolism markers was revealed: CTX – by an average of 29.7%, and P1NP – by an average of 25.5%. ARs were post-dose reactions that occurred within the first 48 hours after drug infusion. Remote ARs, fractures of peripheral bones and vertebrae were not recorded.Conclusion. The use of the generic drug of zoledronic acid has demonstrated its positive effect on BMD and markers of bone metabolism, as well as safety.

THEORETICAL BASIS OF FORMATION AND MANAGEMENT OF THE COMMODITY ASSORTMENT OF THE ORGANIZATION OF WHOLESALE TRADE OF MEDICINES

Abstract: For Russian drug wholesalers (pharmaceutical distributors), the study of the profitability of a range of goods and services is becoming increasingly important. This is due to a number of specific conditions for the functioning of the pharmaceutical market, namely, its territorial scope; high level of competition in the wholesale segment; significant influence of government regulation on pharmaceutical activities in general and assortment policy management, in particular. The purpose of the study was to analyze the scientific and methodological foundations for the formation of a product range and management of the assortment policy in the wholesale segment of the pharmaceutical market. The methods of bibliographic and content analysis, analytical, direct observation and comparison were used as the scientific apparatus of the research. From the beginning of its formation to the present time, the Russian pharmaceutical market has a range of socio-economic, geographical, logistic and other features that have led to the formation of a powerful network of pharmaceutical distributors characterized by a high level of competition. The purpose of the assortment policy is to form the optimal product assortment of the organization for solving its strategic market goals, depending on the current and future needs of the market. One of the mechanisms for the formation of a product range in a wholesale organization is the development of an assortment matrix - a complete assortment list of goods corresponding to the required width and depth of product filling. An analysis of the regulatory legal regulation of the sphere of circulation of medicines shows that the process of forming the drug assortment is significantly influenced by institutional norms, which, on the one hand, provide a guaranteed demand for medicines to provide privileged categories of citizens and a minimum pharmaceutical assortment, and on the other hand, they limit profitability, due to state regulation of selling prices, as well as the growth of costs for their logistics and maintenance in stocks.As a result of the study, it was found that the scientific and methodological foundations of assortment policy management, based on planning, organization and control, including permanent structural analysis of consumer demand, adequate inventory management and marketing analysis of the pharmaceutical market, allow to optimize the financial results of a pharmaceutical distributor in an intensely competitive environment.

Extraction of the Relations among Significant Pharmacological Entities in Russian-Language Reviews of Internet Users on Medications

Nowadays, the analysis of digital media aimed at prediction of the society’s reaction to particular events and processes is a task of a great significance. Internet sources contain a large amount of meaningful information for a set of domains, such as marketing, author profiling, social situation analysis, healthcare, etc. In the case of healthcare, this information is useful for the pharmacovigilance purposes, including re-profiling of medications. The analysis of the mentioned sources requires the development of automatic natural language processing methods. These methods, in turn, require text datasets with complex annotation including information about named entities and relations between them. As the relevant literature analysis shows, there is a scarcity of datasets in the Russian language with annotated entity relations, and none have existed so far in the medical domain. This paper presents the first Russian-language textual corpus where entities have labels of different contexts within a single text, so that related entities share a common context. therefore this corpus is suitable for the task of belonging to the medical domain. Our second contribution is a method for the automated extraction of entity relations in Russian-language texts using the XLM-RoBERTa language model preliminarily trained on Russian drug review texts. A comparison with other machine learning methods is performed to estimate the efficiency of the proposed method. The method yields state-of-the-art accuracy of extracting the following relationship types: ADR–Drugname, Drugname–Diseasename, Drugname–SourceInfoDrug, Diseasename–Indication. As shown on the presented subcorpus from the Russian Drug Review Corpus, the method developed achieves a mean F1-score of 80.4% (estimated with cross-validation, averaged over the four relationship types). This result is 3.6% higher compared to the existing language model RuBERT, and 21.77% higher compared to basic ML classifiers.

Chaga birch mushroom: anti-inflammatory, antioxidant, immunomodulatory, antiviral effects, the possibility of using the Russian drug BioChaga in patients with novel coronavirus infection (COVID-19)

Chaga birch mushroom: anti-inflammatory, antioxidant, immunomodulatory, antiviral effects, the possibility of using the Russian drug BioChaga in patients with novel coronavirus infection (COVID-19)

Application of vitamin D, Russian drug Osteo-Vit D<sub>3</sub> in the complex prevention of osteoporosis and osteoporotic fractures in children and teenagers

Application of vitamin D, Russian drug Osteo-Vit D<sub>3</sub> in the complex prevention of osteoporosis and osteoporotic fractures in children and teenagers

Chronic venous insufficiency after COVID-19: management of edema and pain syndromes

Introduction. COVID-19 infection raises many questions regarding the health condition of patients after they have had COVID-19. The aim of this study is to examine the characteristic symptoms of chronic venous insufficiency in the postcovid period.Materials and methods. The materials that were used for work included the results of studying the medical aid appealability, characteristic symptoms, diagnosis and treatment of symptoms of chronic venous insufficiency in persons who have had the coronavirus infection. 47 patients presented with complaints about deterioration of their condition after they had had COVID-19 over March to September 2021 period. Methods: general clinical examiniation, ultrasound angioscanning of veins of the lower extremities, laboratory coagulation tests.Results and discussion. Before deterioration, calf circumference was measured 22–24 cm at a typical measurement site in most patients (89%), after covid infection it reached 26–27 cm. Varicose veins remained soft, without intravascular formations, edema was often bilateral, asymmetric, pain was described as constant (5–6 VAS scores), patients had prominent signs of lymphostasis. 35 out of 47 people received diosmin-based venotonic drug of Russian manufacture at a dose of 1000 mg/day (one tablet twice a day), the course of treatment lasted one to two months. After that period, the edema subsided in 85% of patients, the severity of pain syndrome significantly reduced (up to 2–3 VAS scores). With regard to chronic venous insufficiency in patients with chronic diseases of lower extremity veins (mostly varicose and post-thrombotic diseases), the significant progress of disease was observed in almost 94% of follow-up cases. Diosmin is the main drug that is prescribed to treat chronic venous insufficiency. The drug has an angioprotective and venotonic effect, reduces the vein wall elasticity, increases venous tone, and decreases venous stasis, reduces capillary permeability and fragility, and increases their resistance, improves microcirculation and lymphatic drainage.Сonclusions. In the postcovid period, clinical symptoms of some chronic diseases occur/worsen, including clinical manifestations of chronic venous insufficiency. The use of Russian diosmin-based drug for the management of edema and pain syndrome is very promising.

Illegal drug sales in the mirror of the dark web marketplace

Abstract Background Studies of the epidemiology of substance use are problematic by the disorder's nature and the illegal character of the substances' turnover. For safety, the illegal substances' markets had moved to the Internet, to the less transparent darknet part. The objective of this study was to get estimates for the Russian drug market using data collected at dark net market ‘Hydra', get the amounts of drugs offered, the relative frequency of offers, and the regional distribution of the market activities. We analyze the relationship between estimates of the illegal drug market with traditional indicators of drug use disorders on the next stage. Methods We use two types of data: 1) Deep Web Black Market data; 2) Official Russian statistical indicators related to drug use. We use Python program via VPN service to extract data. R software was employed for statistical analysis to build the maps of drug offerings and sales by the regions of Russia. Er use the descriptive statistics and correlation analysis to compare the estimates with the state statistics. Results Using the estimates of sales for the drug classes in grams by region (per 100000 population), we mapped the data and found that there is a correlation with the registered drug users and drug-related deaths. There is no Hydra sales of opiates in some regions indicating that older supply channels are still active. Total drug sales and offers championed by cannabis, opiates/opioids, cocaine, amphetamines and the other drugs in smaller amounts. There is a significant correlation between the supply of opiates in regions of Russia and the official incidence of fatal drug poisoning (r = 0.41; p = 0.003), and the number of HIV positive injected drug users (r = 0.47; p = 0.002). Key messages Analysis of the deep internet sales of drugs helps assess the situation with the illegal drug supply in the regions of Russia. Data on deep internet sales of drugs should not substitute the other sources of data.

Attitude to reproduced disease modifying therapies in patients with relapsing-remitting multiple sclerosis: results of a medical and sociological study

The problem of an adequate choice of a treatment method in multiple sclerosis (MS) remains one of the most urgent in modern neurology. The number of patients and the cost of drugs are increasing, leading to an increased MS societal burden. However, treatment costs can be reduced due to the introduction of generic drugs, including domestic ones, which price is significantly lower.Objective: to assess the attitude of Russian patients to the reproduced disease modifying therapies (DMTs) and features influencing an attitude to the replacement from the original to the reproduced drug.Patients and methods. We interviewed 300 patients from six regions of the Russian Federation, receiving interferon beta-1a 44 μg, interferon beta-1b, glatiramer acetate, and teriflunomide, who had an experience of switching from an original drug to a domestic biosimilar drug or generic not earlier than 2009.Results and discussion. The majority of patients (63%) do not notice any changes due to drug replacement from the original to the generic one, some (28%) experience a deterioration in their well-being, and others (7%) experience an improvement in their condition. Young patients (up to 30 years) are relatively less likely to notice a deterioration in well-being after drug replacement. The clinical deterioration after drug replacement is much more often experienced by the patients whose drug was replaced in a pharmacy (74% of cases) and not by the attending clinician (only 54% of cases of deterioration). The majority (87%) of patients with relapsing-remitting MS (RRMS) did not interrupt the treatment after replacement; 13% of respondents reported that they had stopped taking the drug. Among them, there were much more patients whose drug was replaced in a pharmacy, and not due to clinician recommendation (more than 80% of such cases). Adverse reactions to a new drug are another reason for drug withdrawal (20% of all withdrawals). Patients receiving interferon beta-1b have a higher negative attitude towards domestic DMTs: 52% of the respondents gave negative feedback (compared to 20–35% in other groups). Relatively higher loyalty to Russian DMTs was observed in patients receiving interferon beta-1a (20% of negative feedback, which is noticeably lower than in other groups) and teriflunomide (a relatively higher proportion of positive feedback to Russian drugs – 25% compared to 11–16% in other groups). The majority (76%) of the respondents noted that they are interested in learning more about the development and registration of new Russian drugs.Conclusion. The majority of RRMS patients do not tend to have a negative attitude towards Russian DMTs. Consequently, the proportion of ratings in favor of Russian DMTs exceeds the weight of ratings against them. The key priority in the formation of loyalty to Russian DMTs should be changing the perception of adverse reactions. This will significantly increase the adherence to therapy and the quality of the provided treatment.

Sedative-Hypnotic Agents That Impact Gamma-Aminobutyric Acid Receptors: Focus on Flunitrazepam, Gamma-Hydroxybutyric Acid, Phenibut, and Selank.

There are many nonopioid central nervous system depressant substances that share a gamma-aminobutyric acid (GABA) receptor-related mechanism of action. These sedatives-hypnotics can be indicated to treat anxiety, seizures, depression, and insomnia but are also used as substances of abuse and used to facilitate sexual assault. Barbiturates, methaqualone, and glutethimide were among the first type A GABA receptor-mediated sedative-hypnotics. Their clinical use was limited for most indications by serious adverse events and strong abuse potential but continue to be used illicitly around the world. The benzodiazepines supplanted barbiturates for most indications because they were less likely to cause severe adverse events in monotherapy. Flunitrazepam is a newer benzodiazepine that is preferentially used recreationally and to facilitate sexual assault. Flunitrazepam has greater potency and higher affinity for the type A GABA receptor than most benzodiazepines. Gamma-hydroxybutyric acid is sought illicitly for its hypnotic, euphoric and anabolic effects as well as to facilitate sexual assault. When any of these GABAergic drugs are used in high doses or with other sedative hypnotic agents, respiratory depression, coma, and death have occurred. Chronic use of these GABAergic drugs can lead to significant withdrawal syndromes. Phenibut and selank are poorly studied Russian drugs with GABAergic mechanisms that are inexplicably sold to US consumers as dietary supplements. Poison control center calls regarding phenibut have increased substantially over the past 5 years. Desired euphoriant effects account for the recreational and illicit use of many GABA-modulating agents. However, illicit use can lead to significant toxicities related to abuse, dependence, and subsequent withdrawal syndromes. Significant evaluation of developing agents with GABA properties should be conducted to determine abuse potential before public access ensues.

Innovative profile of the Russian pharmaceutical industry

InnoThe article examines the specifics of innovative activity of Russian drug manufacturers, which in the context of a COVID-19 pandemic become a matter of national security. The research is based on panel data: out of a total of 1,816 enterprises in the industry, a sample of 345 innovatively active enterprises is formed with a time series of data 20 years long. The sample is diversified by the scale of enterprise activity into 4 groups: micro enterprises, small, medium, and large enterprises. These types of enterprises are compared both in absolute terms — size of investments in intangible assets, age, and in relative ones — frequency of investments in innovations, coefficient of autonomy, profitability of sales and assets, share of intangible assets in revenue and assets. The analysis was supplemented by enterprises not included in the sample to identify the effectiveness of innovation in the industry. The result is the innovative profile of industrial enterprises in the context of the scale of their activities. The conclusion is drawn about the specifics of the domestic pharmaceutical industry innovation activity, which generally coincides with the established distribution of roles in the global pharmaceutical industry, when large enterprises are leaders in the innovations development and implementation. Russian large companies also tend to use micro enterprises to implement risky projects. The authors conclude that in Russia, the foundations have been formed for transition to a new model of pharmaceutical industry innovative development. This model is based on cooperation of small and large businesses.

Pain reliever combinations in treatment of patients with acute musculoskeletal back pain

Objective: to compare the clinical efficacy of complex therapy, including a combination of a nonsteroidal anti-inflammatory drug (NSAID) with a muscle relaxant and B vitamins in acute musculoskeletal back pain (MSBP). Patients and methods. We enrolled 66 patients with acute MSBP, 27 men and 39 women, mean age – 52.8 [29.4; 68.8] years. All patients had different pain localization: 36 (54.5%) – lumbodynia, 22 (33.3%) – cervicodynia, 8 (12.2%) – thoracodynia. Visual analog scale (VAS) was used to assess pain intensity. Patients in the 1 st group (n=32) were prescribed with complex therapy, including Russian drugs meloxicam (Amelotex 15 mg per day), tolperison (Kalmirex), and a neurotropic multivitamin supplement Compligam B. Patients in the 2 nd group (n=34) received a combination of only two of the three drugs. We assessed pain intensity with VAS, disability duration, and treatment effectiveness from the doctor's and patient's perspectives. Results and discussion. After 5 days of treatment, pain regression was noted in both groups; pain reduction by 50% or more from the initial level prevailed in 1 st group (p=0.03). A rapid NSAID dose decrease prevailed in the 1 st group; from the 5 th to the 10 th day, all patients switched to the 7.5 mg meloxicam dose. The duration of temporary disability in the 1 st group was less than 7 days, in the 2 nd group – 9 days (p<0.05). Complex therapy in group 1 was more effective than therapy in group 2, according to doctors and patients (p<0.05). Conclusion . The combination of NSAID with a muscle relaxant and B vitamins can reduce the duration and the incidence of adverse drug reactions of NSAID therapy, and reduce the duration of temporary disability.

Pandemic as an additional criminality factor

The prerequisite for the study was the emerging new “coronavirus” disease, viewed as a criminality factor. The objective of the study is to identify new characteristics of crime in the context of the incidence of coronavirus in the population, to identify its highly latent types, to reflect the dynamics. The following methods were used to achieve the objective: analysis, synthesis, generalization, statistical method, content analysis, method of expert assessments. The results of the work were the revealed patterns of crime in the sphere of illegal circulation of drugs, weapons, and domestic violence. The novelty is the identification of highly latent types of crime during a pandemic and its characteristic features. Issues related to the prevention of domestic violence during a pandemic with the participation of law enforcement agencies and guardianship authorities in this work were considered. The draft laws “On responsibility for domestic violence” and “On restricting the removal of children from the family” were discussed, recommendations for their improvement were provided. Attention is focused on the practicability of strengthening preventive measures in the fight against domestic violence to preserve families and ensure the interests of children. An increase in the number of drug crimes was revealed during the pandemic, both in Russia and abroad. The Russian drug market is experiencing a shortage of smuggled drugs. It is reoriented to synthetic drugs with new underground drug laboratories being opened. The main contingent of attraction to drug use is still young people and adolescents, the main method – using Internet technologies. The increase in the number of crimes in the sphere of illegal arms trafficking was provoked by the factor of fear, due to the presence of the threat of becoming a victim of selfish and violent crimes. The consequence is consumer panic and an increase in the need of the Russian population for self-defense.