Briukhanova T. O., Nakonechna O. A., Babenko O. V

CURRENT STATUS, PROBLEMS AND PROSPECTS OF ULCERATIVE COLITIS MEDICAL CORRECTION (LITERATURE REVIEW)

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Briukhanova T. O., Nakonechna O. A., Babenko O. V

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LITERATURE REVIEWS

Type of article:

Scientific article

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The article highlights modern data on the prevalence, pathogenesis and mechanisms of development of ulcerative colitis, its forms and classification criteria. Ulcerative colitis has a high medical and social significance due to the rapid rate of spread, especially among young people of working age. In addition, this disease is characterized by rapid progression, accompanied by a significant decrease in the quality of life and, in some cases, leads to disability. The goal is to analyze the features of pharmacotherapy schemes available in open sources of scientific information (guidelines, recommendations, clinical guidelines, results of randomized clinical trials, etc.), key features of the main groups of drugs - their advantages and disadvantages for use in different forms of ulcerative colitis by severity, their feasibility use in specific clinical situations. An analytical comparison of different groups of drugs (5-aminosalicylic acid, corticosteroids, calcineurin inhibitors, cytostatics, infliximab, etc.) for use in ulcerative colitis pharmacotherapy regimens was conducted: criteria for choosing a particular pharmacotherapeutic group, application features, safety profile of therapy. The authors elaborated modern clinical recommendations, instructions and results of clinical studies regarding the practicality and prospects of using current drugs for the treatment of ulcerative colitis, analyzed the safety profile of the therapy and the impact on the further prognosis - regarding the progression of the pathology and the need for surgical treatment. It was revealed that, despite the relatively wide arsenal of drugs for the therapy of ulcerative colitis, specialists in clinical practice face difficulties that mainly relate to insufficient treatment efficiency, the presence of severe side effects or low patient compliance, which in general, significantly affects the quality of pharmacotherapy and the prognosis. Accordingly, the urgent problem is the further search and research of new areas of pharmacological correction of ulcerative colitis, which could improve existing therapy schemes. Conclusions were made about the prospects for further research in this direction.

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Bibliography:

1. Meier J, Sturm A. Current treatment of ulcerative colitis. Gastroenterol. 2011;17(27):3204-12.
2. Segal JP, LeBlanc JF, Hart AL. Ulcerative colitis: an update. Clinical Medicine. 2021;21(2):135.
3. Dulai PS, Jairath V. Acute severe ulcerative colitis: latest evidence and therapeutic implications. Therapeutic advances in chronic disease. 2018;9(2):65-72.
4. Kucharzik T, Koletzko S, Kannengiesser K, Dignass A. Ulcerative colitis — Diagnostic and therapeutic algorithms. Deutsches Ärzteblatt International. 2020;117(33-34):564-574.
5. Raine T, Bonovas S, Burisch J, Kucharzik T, Adamina M, Annese V, et al. ECCO guidelines on therapeutics in ulcerative colitis: medical treatment. Journal of Crohn’s and Colitis. 2022;16(1): 2-17.
6. Panés J, Alfaro I. New treatment strategies for ulcerative colitis. Expert Review of Clinical Immunology. 2017;13(10):963-973.
7. Harbord M, Eliakim R, Bettenworth D, Karmiris K, Katsanos K, Kopylov U, et al. Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 2: current management. Journal of Crohn’s and Colitis. 2017;11(7):769-784.
8. Kornbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010;105:501-523.
9. Caprilli R, Gassull MA, Escher JC, Moser G, Munkholm P, Forbes A, et al. European evidence based consensus on the diagnosis and management of Crohn‘s disease: special situations. Gut. 2006;55(1):i36-i58.
10. ravis SP, Stange EF, Lémann M, Oresland T, Chowers Y, Forbes A, et al. European evidence based consensus on the diagnosis and management of Crohn‘s disease: current management. Gut. 2006;55(1):i16-i35.
11. Stange EF, Travis SP, Vermeire S, Beglinger C, Kupcinkas L, Geboes K, et al. European evidence based consensus on the diagnosis and management of Crohn‘s disease: definitions and diagnosis. Gut. 2006;55 (Suppl 1): i1-i15.
12. Wu B, Tong J, Ran Z. Tacrolimus therapy in steroid-refractory ulcerative colitis: a review. Inflammatory bowel diseases. 2020;26(1):24-32.
13. Murray A, Nguyen TM, Parker CE, Feagan BG, MacDonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev. 2020 Aug 12;8(8):CD000543.
14. Feagan BG, MacDonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev. 2012 Oct 17;10:CD000544.
15. George LA, Cross RK. Cross. Treatment of ulcerative colitis with steroids (in whom, how long, what Dose, what form). Gastroenterology Clinics. 2020;49(4):705-716.
16. Berends SE, Strik AS, Löwenberg M, D’Haens GR, Mathôt RA. Clinical pharmacokinetic and pharmacodynamic considerations in the treatment of ulcerative colitis. Clin Pharmacokinet. 2019;58:15-37.
17. Louis E, Paridaens K, Al Awadhi S, Begun J, Cheon JH, Dignass AU. Modelling the benefits of an optimised treatment strategy for 5-ASA in mild-to-moderate ulcerative colitis. BMJ Open Gastroenterol. 2022;9(1) e000853.
18. Saha SK, Panwar R, Kumar A, Pal S, Ahuja V, Dash NR, et al. Early colectomy in steroid-refractory acute severe ulcerative colitis improves operative outcome. International journal of colorectal disease. 2018;33:79-82.
19. Komaki Y, Komaki F, Micic D, Yamada A, Suzuki Y, Sakuraba A. Pharmacologic therapies for severe steroid refractory hospitalized ulcerative colitis: a network meta-analysis. Journal of Gastroenterology and Hepatology. 2017;32(6):1143-1151.
20. Kevans D, Murthy S, Mould DR, Silverberg MS. Accelerated clearance of infliximab is associated with treatment failure in patients with corticosteroid-refractory acute ulcerative colitis. Journal of Crohn’s and Colitis. 2018;12(6):662-669.
21. Hoffmann P, Wehling C, Krisam J, Pfeiffenberger J, Belling N, Gauss A. Performance of tacrolimus in hospitalized patients with steroidrefractory acute severe ulcerative colitis. World Journal of Gastroenterology. 2019;25(13):1603.
22. Song EM, Oh EH, Hwang SW, Park SH, Yang DH, Byeon JS, et al. Comparison of outcomes of cyclosporine A and infliximab for steroid‐ refractory acute severe ulcerative colitis. Journal of Gastroenterology and Hepatology. 2021;36(9):2463-2470.
23. Ordás I, Domènech E, Mañosa M, García-Sánchez V, Iglesias-Flores E, Peñalva M, et al. Long-term efficacy and safety of cyclosporine in a cohort of steroid-refractory acute severe ulcerative colitis patients from the ENEIDA registry (1989–2013): a nationwide multicenter study. Official journal of the American College of Gastroenterology| ACG. 2017;112(11):1709-1718.
24. Ollech JE, Dwadasi S, Rai V, Peleg N, Normatov I, Israel A, et al. Efficacy and safety of induction therapy with calcineurin inhibitors followed by vedolizumab maintenance in 71 patients with severe steroid-refractory ulcerative colitis. Alimentary Pharmacology & Therapeutics. 2020;51(6):637-643.
25. Pugliese D, Felice C, Papa A, Gasbarrini A, Rapaccini GL, Guidi L, et al. Anti TNF-α therapy for ulcerative colitis: current status and prospects for the future. Expert Review of Clinical Immunology. 2017;13(3):223-233.
26. Pugliese D. Anti TNF-α therapy for ulcerative colitis: current status and prospects for the future. Expert Review of Clinical Immunology. 2017;13:223-233.
27. Shah SC, Naymagon S, Panchal HJ, Sands BE, Cohen BL, Dubinsky MC. Accelerated infliximab dosing increases 30-day colectomy in hospitalized ulcerative colitis patients: a propensity score analysis. Inflammatory bowel diseases. 2018;24(3):651-659.
28. Sandborn WJ, Vermeire S, Tyrrell H, Hassanali A, Lacey S, Tole S. Etrolizumab for the treatment of ulcerative colitis and Crohn’s disease: an overview of the phase 3 clinical program. Adv Ther. 2020;37:3417-31.
29. Guo C, Wu K, Liang X, Liang Y, Li R. Infliximab clinically treating ulcerative colitis: A systematic review and meta-analysis. Pharmacological Research. 2019;148:104455.
30. Oh SJ, Shin GY, Soh H, Lee JG, Im JP, Eun CS, et al. Long-term outcomes of infliximab in a real-world multicenter cohort of patients with acute severe ulcerative colitis. Intestinal research. 2021;19(3):323.
31. Choy MC, Seah D, Gorelik A, An YK, Chen CY, Macrae FA, et al. Predicting response after infliximab salvage in acute severe ulcerative colitis. Journal of gastroenterology and hepatology. 2018;33(7):1347-1352.
32. Mizuno S, Ono K, Mikami Y, Naganuma M, Fukuda T, Minami K, et al. 5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis. Intestinal research. 2020;18(1):69.
33. Hibiya S, Matsuyama Y, Fujii T, Maeyashiki C, Saito E, Ito K, et al. 5-aminosalicylate–intolerant patients are at increased risk of colectomy for ulcerative colitis. Alimentary Pharmacology & Therapeutics. 2021;53(1):103-113.
34. Herfarth H, Barnes EL, Valentine JF, Hanson J, Higgins PDR, Isaacs KL, et al. Methotrexate is not superior to placebo in maintaining steroid-free response or remission in ulcerative colitis. Gastroenterology. 2018;155(4):1098-1108.

Publication of the article:

«Bulletin of problems biology and medicine», 2023 Issue 3, 170, 28-39 pages, index UDC 616.345-002.44

DOI:

10.29254/2077-4214-2023-3-170-28-39