Steroid resistance in inflammatory bowel diseases: mechanisms of development, physician's tactics in choosing therapy for a patient

This review highlights the problem of steroid resistance in the treatment of inflammatory bowel diseases (IBD). The pathway of glucocorticosteroids in the human body, extragenomic and genomic effects of drugs are described in detail. The analysis and systematization of possible models of steroid resistance in IBD are carried out. The need to use current statistical data when choosing drugs for patients with steroid resistance is emphasized. It is determined that the most effective option for selecting therapy, in this case, may be the genetically engineered biological drug ustekinumab.