TherapyTherapyТерапия2412-40362713-1823Bionika Media71758610.18565/therapy.2026.5.15-27ORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯResearch ArticleEvaluation of the efficacy and safety of the combined use of 5-aminosalicylic acid and genetically engineered biological drugs in patients with moderate ulcerative colitisОценка эффективности и безопасности комбинированного применения препаратов 5-аминосалициловой кислоты и генно-инженерных биологических препаратов у пациентов со среднетяжелым язвенным колитомhttps://orcid.org/0000-0001-7250-09773268-0360KnyazevOleg V.КнязевОлег Владимирович
Russian Federation

MD, Dr. Sci. (Medicine), head of the Department of intestinal pathology, head of the Moscow State Center of Gastroenterology

д. м. н., заведующий отделом патологии кишечника, руководитель МГГЦ

oleg7@bk.ruhttps://orcid.org/0000-0003-4984-95263090-7083PriymakMaxim A.ПриймакМаксим Александрович
Russian Federation

MD, deputy chief physician for medical affairs

заместитель главного врача по медицинской части

m.priymak@mknc.ruhttps://orcid.org/0000-0002-3818-62054086-6745KagramanovaAnna V.КаграмановаАнна Валерьевна
Russian Federation

MD, PhD (Medicine), head of the Department of intestinal pathology

к. м. н., заведующая отделением патологии кишечника

a.kagramanova@mknc.ruhttps://orcid.org/0000-0001-7891-27029369-9674LishchinskayaAlbina A.ЛищинскаяАльбина Александровна
Russian Federation

MD, PhD (Medicine), senior researcher at the Department of intestinal pathology

к. м. н., старший научный сотрудник отдела патологии кишечника

lalbina@inbox.ruhttps://orcid.org/0000-0002-0524-25146047-7590FadeevaNina A.ФадееваНина Александровна
Russian Federation

MD, PhD (Medicine), head of the Department of gastroenterology, associate professor of the Department of gastroenterology, chief freelance gastroenterologist of the North-Western Administrative District (Department of Healthcare of Moscow)

к. м. н., заведующая гастроэнтерологическим отделением, доцент кафедры гастроэнтерологии, главный внештатный специалист-гастроэнтеролог СЗАО ДЗМ

n.fadeeva@mknc.ruhttps://orcid.org/0009-0007-5952-62337199-3201DemchenkoAlexandra N.ДемченкоАлександра Николаевна
Russian Federation

gastroenterologist at the Department of intestinal pathology

врач-гастроэнтеролог отделения патологии кишечника

oleg7@bk.ruA.S. Loginov Moscow Clinical Scientific CenterГБУЗ «Московский клинический научный центр имени А.С. Логинова Департамента здравоохранения Москвы»Research Institute for Healthcare and Medical Management OrganizationГБУ «Научно-исследовательский институт организации здравоохранения и медицинского менеджмента Департамента здравоохранения города Москвы»Russian Medical Academy of Continuous Professional EducationФГАОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России2908202612515272808202628082026Copyright ©; 2026, “Bionika Media” LLCCopyright ©; 2026, ООО «Бионика Медиа»2026“Bionika Media” LLCООО «Бионика Медиа»https://journals.eco-vector.com/2412-4036/about/editorialPolicieshttps://journals.eco-vector.com/2412-4036/article/view/717586

Currently, there is no sufficient data to determine the indications for continuing 5-aminosalicylic acid (5-ASA) therapy in patients who have been prescribed genetically engineered biological drugs (GEBDs) due to their inefficiency. Currently, 60–80% of patients continue to receive 5-ASA concomitantly with GEBDs, despite previously documented inefficiency of 5-ASA monotherapy. Since the treatment of inflammatory bowel diseases is associated with high costs, there is a significant need to reduce unnecessary costs in the treatment of patients with ulcerative colitis (UC) and Crohn’s disease.

The aim: to study the efficacy and safety of the combined use of 5-ASA and GEBDs in patients with moderate UC.

Material and methods. For the study, four groups of patients were formed depending on the therapy administered: Group 1 – 68 (26.6%) biologic-naive patients with UC who received combination therapy with infliximab (INFL) and 5-ASA; Group 2 – 60 (23.4%) biologic-naive patients with UC who received monotherapy with INFL without 5-ASA; Group 3 included 73 (28.5%) patients with UC who had previously received GEBDs before receiving IFNL therapy and were continuing to use 5-ASA; Group 4 included 55 (21.5%) patients with UC who had used GEBDs before receiving IFNL therapy and were not receiving 5-ASA. The secondary endpoint was colonic mucosal (CM) healing with a Mayo score of 0.

Results. When comparing groups 1 and 4 of UC patients, we found that in bionaive and non-bionaive patients, the probability of CM healing with a combination of GEBDs (INFL) and 5-ASA drugs was higher than with therapy without 5-ASA (OR 9.402; 95% CI: 4.111–21.499; χ2 = 31.389; p < 0.001), as well as when comparing groups 2 and 4 (OR 5.281; 95% CI: 2.358–11.831; χ2 = 17.325; p < 0.001).

Conclusion. To achieve colonic mucosal healing (Mayo index = 0 points) in patients with UC previously treated with TNF-α inhibitors, a combination of biologic agents and 5-ASA preparations is advisable.

На сегодняшний день недостаточно данных, определяющих показания к продолжению приема препаратов 5-аминосалициловой кислоты (5-АСК) пациентами, у которых в связи с их неэффективностью назначены генно-инженерные биологические препараты (ГИБП). В настоящее время 60–80% больных одновременно c ГИБП продолжают получать 5-АСК, несмотря на зафиксированную ранее неэффективность монотерапии последними. Поскольку терапия воспалительных заболеваний кишечника сопряжена с высокими затратами, существует значительная потребность в снижении неоправданных расходов на лечение пациентов с язвенным колитом (ЯК) и болезнью Крона.

Цель – изучить эффективность и безопасность комбинированного применения препаратов 5-АСК и ГИБП у пациентов с ЯК средней степени тяжести.

Материал и методы. В рамках исследования в зависимости от проводившейся терапии были сформированы 4 группы пациентов: 1-я группа – 68 (26,6%) бионаивных пациентов с ЯК, которые получали комбинированную терапию препаратом инфликсимаба (ИНФЛ) и препаратами 5-АСК; 2-я группа – 60 (23,4%) бионаивных пациентов с ЯК, которые получали монотерапию препаратом ИНФЛ без 5-АСК; 3-я группа – 73 (28,5%) пациента с ЯК, которые ранее, до назначения терапии ИНФЛ, получали ГИБП и продолжают применять препараты 5-АСК; 4-я группа – 55 (21,5%) пациентов с ЯК, которые использовали ГИБП до назначения терапии ИНФЛ и не получают препараты 5-АСК. Конечной вторичной точкой являлось заживление слизистой оболочки толстой кишки (СОТК) по индексу Мейо 0 баллов.

Результаты. При сравнении 1-й и 4-й групп больных ЯК нами установлено, что у бионаивных и небионаивных пациентов вероятность заживления СОТК при сочетании ГИБП (ИНФЛ) с препаратами 5-АСК, выше, чем при применении терапии без 5-АСК (ОШ 9,402; 95% ДИ: 4,111–21,499; х2 = 31,389; р < 0,001), так же как и при сравнении 2-й и 4-й групп (ОШ 5,281; 95% ДИ: 2,358–11,831; х2 = 17,325; р < 0,001).

Заключение. Для достижения заживления СОТК (индекс Мейо = 0 баллов) у пациентов с ЯК, ранее получавших ингибиторы ФНО-α, целесообразно применение комбинации ГИБП и препаратов 5-АСК.

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