Pharmacotherapy of inflammatory bowel diseases: efficacy performance and safety management

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Abstract

Treatment of inflammatory bowel diseases – IBD (Crohn’s disease, ulcerative colitis) is aimed at achieving clinical, endoscopic and histological remission, minimizing surgical complications, and ensuring a normal quality of life. However, the use of medical treatment is potentially associated with various adverse events, among which infectious complications, malignant neoplasms, as well as myelotoxicity, hepatotoxicity, skin lesions and others. The risk of side effects depends on the type of drug therapy (5-aminosalicylates, thiopurines, biologicals, etc.), the duration of treatment, the presence of extra-intestinal manifestations, etc. The article provides an overview of data on both the effectiveness and frequency of various side effects of the main classes of drugs in IBD, presents methods of investigation which can predict the effectiveness and development of side effects, the implementation of which can be considered as a variant of personalized therapy in IBD.

About the authors

Igor G. Bakulin

Mechnikov North-Western State Medical University

Email: mskalinskaya@yahoo.com
ORCID iD: 0000-0002-6151-2021

доктор медицинских наук, профессор, заведующий кафедрой пропедевтики внутренних болезней, гастроэнтерологии и диетологии

Russian Federation, Saint Petersburg

Maria I. Skalinskaya

Mechnikov North-Western State Medical University

Author for correspondence.
Email: mskalinskaya@yahoo.com
ORCID iD: 0000-0003-0769-8176

кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Saint Petersburg

Igor V. Maev

Yevdokimov Moscow State University of Medicine and Dentistry

Email: mskalinskaya@yahoo.com
ORCID iD: 0000-0001-6114-564X

академик РАН, доктор медицинских наук, профессор, заведующий кафедрой пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

Ekaterina V. Skazyvaeva

Mechnikov North-Western State Medical University

Email: mskalinskaya@yahoo.com
ORCID iD: 0000-0002-8563-6870

кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Saint Petersburg

Mariia S. Zhuravleva

Mechnikov North-Western State Medical University

Email: mskalinskaya@yahoo.com
ORCID iD: 0000-0003-4838-5707

кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Saint Petersburg

Larisa B. Gaikovaya

Mechnikov North-Western State Medical University

Email: mskalinskaya@yahoo.com
ORCID iD: 0000-0003-1000-1114

доктор медицинских наук, доцент, заведующий кафедрой биологической и общей химии

Russian Federation, Saint Petersburg

Natalia V. Bakulina

Mechnikov North-Western State Medical University

Email: mskalinskaya@yahoo.com
ORCID iD: 0000-0003-4075-4096

доктор медицинских наук, профессор, заведующий кафедрой внутренних болезней, клинической фармакологии и нефрологии

Russian Federation, Saint Petersburg

Aleksei I. Ermakov

Mechnikov North-Western State Medical University

Email: mskalinskaya@yahoo.com
ORCID iD: 0000-0003-3435-5881

врач клинической лабораторной диагностики центральной клинико-диагностической лаборатории

Russian Federation, Saint Petersburg

Ekaterina S. Alekseenko

Mechnikov North-Western State Medical University

Email: mskalinskaya@yahoo.com
ORCID iD: 0000-0001-8250-4197

врач-ординатор кафедры пропедевтики внутренних болезней, гастроэнтерологии и диетологии

Russian Federation, Saint Petersburg

Kristina N. Ivanova

Mechnikov North-Western State Medical University

Email: mskalinskaya@yahoo.com

врач-ординатор каф. пропедевтики внутренних болезней, гастроэнтерологии и диетологии

Russian Federation, Saint Petersburg

Mikhail V. Solovev

Kirov Military Medical Academy

Email: mskalinskaya@yahoo.com
ORCID iD: 0000-0001-6832-0498

кандидат медицинских наук, доцент, врач-гастроэнтеролог, старший преподаватель кафедры госпитальной терапии

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files
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2. Fig. 1. Nosologic structure of the North-West inflammatory bowel disease (IBD) registry.

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3. Fig. 2. Structure of causes of withdrawal of IBD (data from North-West Centre IBD).

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4. Fig. 3. Pattern of drug change causes for the treatment of IBD in patients with IBD (data from North-West Centre for IBD).

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5. Fig. 4. Structure of drugs used in treatment of IBD at the time of sampling (data from North-West Centre for IBD.

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6. Fig. 6. Current medication therapy in patients with Crohn’s disease (based on analysis of the North-West IBD registry as of 10.05.2021).

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7. Fig. 7. The structure of patients in the North-West IBD registry at date 05.10.2021 by the form and activity of IBD: a – ulcerative colitis activity at the time of the registry report (data from the last visit to the IBD centre), n=741; b – the distribution of ulcerative colitis patients by disease course, n=741; c – Crohn’s disease activity at the time of the registry report (data from the last visit to the IBD centre), n=497; d – the distribution of patients with ulcerative colitis by disease course, n=497.

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8. Fig. 8. Scheme of thiopurine metabolism [30].

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