Systematizing classification of multifocal lesions of gastrointestinal mucosa caused by non-steroidal anti-inflammatory and antithrombotic agents (Moscow Classification)
L.B. Lazebnik, G.V. Belova
1 State budgetary institution of high professional education «Moscow State University of Medicine and Dentistry named after A.I. Evdokimov» of the Ministry of Healthcare of the Russian Federation, Moscow
2 Multidisciplinary Medical Center of the Bank of Russia, Moscow
The aim of the study was to show the modern possibilities of diagnostics of multifocal lesions of the mucosa of the digestive tract against the background of the use of non-steroidal anti-inflammatory drugs (NSAIDs) and antithrombotic agents (АТА) and to present a new classification of mucosal lesions and the possibility of its application for further transition to clinical recommendations as a guide to action. Materials and methods. In order to develop an algorithm for managing patients receiving NSAIDs and anti-thrombotic therapy, as well as classification of lesions of the mucosa of the digestive tract, against the background of the treatment, we used the experience of foreign colleagues and information resources: PubMed, Cochrane Library, DynaMed, Google Scholar, TRIP Database , which today is the most comprehensive in terms of coverage by the public meta-search system, which has an advanced document sorting system, existing normative documents, as well as own experience. The algorythm for management of patients cured with NSAIDs or АТА included assessment of the patient’s condition before the start of treatment, dynamic monitoring of complications based on clinical and laboratory data, endoscopic diagnostic data, and a decision support system in the form of the Russian classification of esophagogastroduodenoenterocolatopathy. Results. The developed Moscow classification of multifocal lesions of the mucosa of the digestive tract with nonsteroidal anti-inflammatory and antithrombotic agents is presented in the form of a cascade that includes a common scale, an expanded (specifying) scale, and a stratification of the risks of recurrence of bleeding and thromboembolic complications. Conclusion. Тhe proposed Moscow classification of lesions of the mucosa of the digestive tract with non-steroidal anti-inflammatory drugs and drugs for lowering blood clotting (L.B. Lazebnik, G.V. Belova) is a testament to the medicine of «Three P» – personified, preventive and predictive, accounting for a significant number of gender, anamnesis, functional and clinical-laboratory indicators. The application of the Russian classification refers to the decision-support system for the tactics of conducting an extremely complex category of patients with severe comorbid pathology.
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About the Autors
Galina V. Belova, MD, deputy chief doctor for ambulatory-outpatient care, head of the polyclinic of Multiprofile medical centre of the Bank of Russia. Address: 117898, Moscow, 66 Sevasopolsky prospect Str. E-mail: belovagv@inbox.ru
Leonid B. Lazebnik, MD, professor of ghe Department of outpatient therapy of A.I. Evdokimov Moscow state university of medicine and dentistry, president of Scientific society of gastroenterologists of Russia, vice president of Russian scientific medical society of therapists
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