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The National Registry of Patients with Inflammatory Bowel Disease (IBD) in the Russian Federation was established to study the epidemiological and clinical characteristics of patients and evaluate the actual clinical practice of medical and surgical treatment.AIM: to analyze the data of patients with IBD in the Russian Federation including clinical and demographic characteristics, medical status of patients, the frequency of use of various classes of drugs and response to treatment, the survival rates of advanced therapy drugs and the reasons for their cancellation.METHODS: from May 2017 to August 2021, depersonalized data of 3827 adult patients with IBD (ulcerative colitis (UC) – 2358 pts, Crohn's disease (CD) - 1469 pts) from 80 regions of the Russian Federation were included in the registry, both with previously and newly diagnosed UCor CD, who are in inpatient or outpatient care.RESULTS: in our population, the ratio of UC: CD was 1.6:1. The distribution of patients by sex was the same. The average age of patients in the registry was 40.6±13.1 (13-83 years) for UC and 38.5±14.3 (15-75 years) for CD, the half of patients were in the age range of 21-40 years for both diseases. The average age of disease onset did not differ for UC and CD and was 35.3 year (12-75 years) and 31.2 year (14-72 years) respectively. The duration between the onset of symptoms and the establishment of a diagnosis was 13.2 months in UC, and statistically significantly longer in CD - 34.8 months (P<0.01). The proportion of smokers in CD patients was statistically significantly higher than in UC ones (14.6% versus 9.6%, respectively, P<0.001). The incidence of disability was also significantly higher in CD than in UC patients (41.7% vs. 29.8%, P<0.01). The diagnosis of mild UC was established in 36% of cases, moderate UC occurred in 48.9% of patients, severe UC in 14.2% of patients. For the first time, the frequency of acute severe UC (1%) was estimated. The majority of patients had total UC (56.8%), 33% had left-side colitis, and 9.4% had proctitis. CD was divided by localization into ileocolitis 55.9%, terminal ileitis 23.9%, colitis 20.2%, perianal lesions were noted in 32.5% of cases. The overall complication rate in CD was 46% (681 patients), of which the most common were strictures - 48% and fistulas- 25.1%.Frequencyof extra intestinal manifestations did not differ in UC and CD patients and was 20.1% (473 patients) and 24.5% (360 patients), respectively. Of these, musculoskeletal lesions were more common (41.6% in UC, 42% in CD), lesions of the skin, eyes, mucous membranes, liver, anemia were also noted. In the treatment of IBD, steroids were used most often (79.3% and 65% in UC and CD, respectively), followed by 5-ASA - 47% in UC, 32.4% in CD. Immunosuppressant’s in CD were prescribed significantly more often (28.4%) than in UC (11%) (p<0.05). Biologics were used in 20.6% of UC patients and in 30% of CD patients. The highest 2-year survival of advanced therapy was noted for ustekinumab in CD (96%), for tofacitinib in UC (89.3%), and for vedolizumab in both UC and CD (92.5% and 88.4% respectively). The survival rates of all TNF-α inhibitors were approximately the same and varied within 58.1-72.4% in UC and 60-70% in CD. The most common reasons for discontinuation of advanced treatment were lack of efficacy/loss of response in both UC and CD. The second common reason was achieving remission. Certolizumab pegol in CD was canceled for this reason most often- 22.7% of cases. A small number of patients discontinued treatment due to adverse events: for UC - 1 patient each on adalimumab, golimumab, and tofacitinib, and 7 patients on infliximab, for CD- 5 patients on infliximab and adalimumab (9.6% and 7.5%, respectively) and 2 patients (4.6%) on certolizumab. Unfortunately, the proportion of discontinuation for non-medical reasons was significant and varied from 7% to 50% for different drugs. In some patients, the reason for discontinuation of therapy remained unknown.CONCLUSION: The difficulties of differential, often untimely diagnosis of CD and UC, the predominance of complicated and severe forms against the background of an increase in morbidity and prevalence, and at the same time the lack of adequate statistical accounting of CD and UC, make it necessary to create a unified clinical register of patients with IBD. The register of IBD patients will provide a holistic picture of the IBD situation in the country, including optimizing the use of budget funds for the treatment of patients with CD and UC, ensuring their rational planning.

Crohn's disease (CD) is a chronic autoimmune disease of the gastrointestinal tract, which mainly affects young people of productive age. Until now, patients with this disease cannot be cured with by conservative therapy or surgery. The effectiveness of drugs for CD is limited, and their use is often accompanied by adverse events. All this creates a need for new drugs, fundamentally different in the action, with high efficiency and a good safety profile. The review is dedicated to a new biological agent for the treatment of CD blocking interleukins 12 and 23, which are involved in the pathogenesis of inflammation in inflammatory bowel diseases. This review presents the data of phases 2 and 3 clinical trials of the agent and the data obtained in real clinical practice, allowing to conclude about the efficacy and safety, as well as its place in the treatment algorithm for CD.

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Introduction. According to clinical guidelines, the treatment of patients with ulcerative colitis (UC) is carried out as combination therapy with mesalazine in rectal forms.The aim was to compare the effectiveness of treatment of moderate severity UC patients receiving mesalazine MMH as monotherapy and mesalazine in combination with mesalazine for rectal use.Materials and methods. Comparative clinical analysis of the results of treatment of patients with moderate UC receiving mesalazine MMX as monotherapy (1st group, 44 patients) and mesalazine in combination with mesalazine for rectal use (microclysters, suppositories) (2nd group, 40 patients) was performed.Results and discussion. After 2 weeks of therapy with mesalazine MMX, 95.0% of the 1st group patients responded to therapy with mesalazine MMX and continued treatment with it as monotherapy (without microclysters and suppositories). In Group 2, 97.2% of patients responded to mesalazine therapy and continued treatment with topical forms of mesalazine - microglia and suppositories. After 12 weeks, 87.5% of the 44 patients in Group 1 who responded to mesalazine MMX therapy and 88.9% of the 40 patients in Group 2 who responded to mesalazine therapy achieved clinical remission. After 52 weeks, 82.5% of 44 Group 1 patients and 86.1% of 40 Group 2 patients remained in clinical remission. The Meio index decreased from 7.9 ± 0.13 to 2.4 ± 0.4 points in group 1 and from 8.0 ± 0.17 to 2.3 ± 0.2 in group 2. There was no statistically significant difference in the level o  laboratory indices between the groups after 12 and 52 weeks (p > 0.05).Conclusion. Our study confirms that continuous regular administration of MMX mesalazine as monotherapy in doses according to the clinical guidelines is comparable in its effectiveness to combined therapy with non prolonged mesalazine and topical forms of mesalazine in patients with UC of moderate severity.

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AIM: to determine the diagnostic efficiency of magnetic resonance enterocolonography using inflammation indices (CDMI, MEGS) in assessing activity of the inflammatory process in the colon and small intestine in Crohn's disease.PATIENTS AND METHODS: the study included 42 patients with Crohn's disease (age ranged from 19 to 47 years). All patients underwent magnetic resonance enterocolonography (MRE) with intravenous contrast and diffusion-weighted images. According to the results of MRE, were determined MR indices of inflammation activity in the small and large intestine - CDMI and MEGS. The MR inflammatory activity indices CDMI and MEGS were compared with the endoscopic inflammatory activity index SES-CD.RESULTS: the MR inflammation activity index CDMI did not show a statistically significant diagnostic efficiency (p>0.05). The MR inflammation activity index MEGS showed a statistically significant diagnostic efficiency (p<0.0001). According to the nomogram, the MR inflammation activity index MEGS demonstrated a high predictive ability to determine the true activity of the inflammatory process in the small and large intestine. Correlation demonstrated direct strong relationship between the quantitative values of the MEGS inflammation indices and the endoscopic inflammation index (SES-CD) (r=0.843, p<0.0001).CONCLUSION: magnetic resonance enterocolonography using the MEGS activity index has a high diagnostic efficiency in assessing the activity of the inflammatory process in the small and large intestine in Crohn's disease. The MR inflammation activity index CDMI did not show statistically significant diagnostic efficacy. The results of the study should be considered preliminary and require further study of the possibilities of these indices of inflammation activity in a larger sample of patients.