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“DIFFICULT” ISSUES OF THE MANAGEMENT OF INFLAMMATORY BOWEL DISEASES PATIENTS

The article presents “difficult” questions found by physicians in the management of inflammatory bowel diseases (IBD) patients, and also discusses and analyzes data of the Register, established by the North-West Center of the IBD (within the framework of the Federal Register of IBD patients). To date, there are many complex and unresolved issues regarding the management of IBD patients. The situation becomes especially relevant when bearing in mind these diseases start at a young and working age and pose a significant social problem. Data on the IBD prevalence rate and their separate forms vary considerably, but almost all available sources report its gain in recent years. The information displays the prevalence rate of IBD, the forms of the disease, the timing of the diagnosis, both the essence and frequency of complications. The obtained data are compared with the results of other registers. To the actual moment, despite the obvious breakthrough in the development of drugs for the treatment of IBD, not all patients can achieve an optimal response, complete relief of the inflammatory process. The discussion touches upon issues related to the immunogenicity of various genetic engineering biological products and its effect on the efficacy and safety of therapy, as well as the efficacy and safety of biosimilars in the treatment of IBD and the problems associated with predicting the effectiveness and safety of the treatment.