Skip to main content
Erschienen in: MMW - Fortschritte der Medizin 3/2016

08.11.2016 | Chronisch-entzündliche Darmerkrankungen | FORTBILDUNG . ÜBERSICHT

Update 2016

Das können Sie heute für CED-Patienten tun

verfasst von: Prof. Dr. med. Torsten Kucharzik

Erschienen in: MMW - Fortschritte der Medizin | Sonderheft 3/2016

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die Einführung neuer Substanzen hat die therapeutischen Optionen bei Colitis ulcerosa und Morbus Crohn deutlich erweitert. Hier sind vor allem neue anti-TNF-Antikörper, aber auch Antiadhäsionsmoleküle mit einem innovativen Wirkmechanismus zu nennen. Hinzu kommt ein Paradigmenwechsel in der Behandlungsstrategie hin zu einer mehr personalisierten Medizin, wobei objektive Zielkriterien wie die Abheilung der Mukosa bzw. die transmurale Heilung als Orientierung gelten.
Literatur
1.
Zurück zum Zitat Dong J, Wang H, Zhao J, Zhu W, Zhang L, Gong J et al. Ultrasound as a diagnostic tool in detecting active Crohn’s disease: a meta-analysis of prospective studies. European radiology. 2014;24(1):26–33. Epub 2013/08/08CrossRefPubMed Dong J, Wang H, Zhao J, Zhu W, Zhang L, Gong J et al. Ultrasound as a diagnostic tool in detecting active Crohn’s disease: a meta-analysis of prospective studies. European radiology. 2014;24(1):26–33. Epub 2013/08/08CrossRefPubMed
2.
Zurück zum Zitat Kucharzik T, Petersen F, Maaser C. Bowel Ultrasonography in Inflammatory Bowel Disease. Dig Dis. 2015;33 Suppl 1:17–25. Epub 2015/09/15CrossRefPubMed Kucharzik T, Petersen F, Maaser C. Bowel Ultrasonography in Inflammatory Bowel Disease. Dig Dis. 2015;33 Suppl 1:17–25. Epub 2015/09/15CrossRefPubMed
3.
Zurück zum Zitat Panes J, Bouzas R, Chaparro M, Garcia-Sanchez V, Gisbert JP, Martinez de Guerenu B et al. Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn’s disease. Alimentary pharmacology & therapeutics. 2011;34(2):125–45. Epub 2011/05/28CrossRef Panes J, Bouzas R, Chaparro M, Garcia-Sanchez V, Gisbert JP, Martinez de Guerenu B et al. Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn’s disease. Alimentary pharmacology & therapeutics. 2011;34(2):125–45. Epub 2011/05/28CrossRef
4.
Zurück zum Zitat Annese V, Daperno M, Rutter MD, Amiot A, Bossuyt P, East J et al. European evidence based consensus for endoscopy in inflammatory bowel disease. Journal of Crohn’s & colitis. 2013;7(12):982–1018. Epub 2013/11/05CrossRef Annese V, Daperno M, Rutter MD, Amiot A, Bossuyt P, East J et al. European evidence based consensus for endoscopy in inflammatory bowel disease. Journal of Crohn’s & colitis. 2013;7(12):982–1018. Epub 2013/11/05CrossRef
5.
Zurück zum Zitat Calabrese E, Maaser C, Zorzi F, Kannengiesser K, Hanauer SB, Bruining DH et al. Bowel Ultrasonography in the Management of Crohn’s Disease. A Review with Recommendations of an International Panel of Experts. Inflammatory bowel diseases. 2016;22(5):1168–83. Epub 2016/03/10CrossRefPubMed Calabrese E, Maaser C, Zorzi F, Kannengiesser K, Hanauer SB, Bruining DH et al. Bowel Ultrasonography in the Management of Crohn’s Disease. A Review with Recommendations of an International Panel of Experts. Inflammatory bowel diseases. 2016;22(5):1168–83. Epub 2016/03/10CrossRefPubMed
6.
Zurück zum Zitat Vande Casteele N, Ferrante M, Van Assche G, Ballet V, Compernolle G, Van Steen K et al. Trough concentrations of infliximab guide dosing for patients with inflammatory bowel disease. Gastroenterology. 2015;148(7):1320–9 e3. Epub 2015/03/01CrossRefPubMed Vande Casteele N, Ferrante M, Van Assche G, Ballet V, Compernolle G, Van Steen K et al. Trough concentrations of infliximab guide dosing for patients with inflammatory bowel disease. Gastroenterology. 2015;148(7):1320–9 e3. Epub 2015/03/01CrossRefPubMed
7.
Zurück zum Zitat Yanai H, Lichtenstein L, Assa A, Mazor Y, Weiss B, Levine A et al. Levels of drug and antidrug antibodies are associated with outcome of interventions after loss of response to infliximab or adalimumab. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2015;13(3):522–30 e2. Epub 2014/07/30CrossRef Yanai H, Lichtenstein L, Assa A, Mazor Y, Weiss B, Levine A et al. Levels of drug and antidrug antibodies are associated with outcome of interventions after loss of response to infliximab or adalimumab. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2015;13(3):522–30 e2. Epub 2014/07/30CrossRef
8.
Zurück zum Zitat Colombel JF, Rutgeerts P, Reinisch W, Esser D, Wang Y, Lang Y et al. Early mucosal healing with infliximab is associated with improved long-term clinical outcomes in ulcerative colitis. Gastroenterology. 2011;141(4):1194–201. Epub 2011/07/05CrossRefPubMed Colombel JF, Rutgeerts P, Reinisch W, Esser D, Wang Y, Lang Y et al. Early mucosal healing with infliximab is associated with improved long-term clinical outcomes in ulcerative colitis. Gastroenterology. 2011;141(4):1194–201. Epub 2011/07/05CrossRefPubMed
9.
Zurück zum Zitat Baert F, Moortgat L, Van Assche G, Caenepeel P, Vergauwe P, De Vos M et al. Mucosal healing predicts sustained clinical remission in patients with early-stage Crohn’s disease. Gastroenterology. 2010;138(2):463–8; quiz e10–1. Epub 2009/10/13CrossRefPubMed Baert F, Moortgat L, Van Assche G, Caenepeel P, Vergauwe P, De Vos M et al. Mucosal healing predicts sustained clinical remission in patients with early-stage Crohn’s disease. Gastroenterology. 2010;138(2):463–8; quiz e10–1. Epub 2009/10/13CrossRefPubMed
10.
Zurück zum Zitat Preiss JC, Bokemeyer B, Buhr HJ, Dignass A, Hauser W, Hartmann F et al. [Updated German clinical practice guideline on „Diagnosis and treatment of Crohn’s disease“ 2014]. Zeitschrift fur Gastroenterologie. 2014;52(12):1431–84. Epub 2014/12/05. Aktualisierte S3-Leitlinie“Diagnostik und Therapie des Morbus Crohn“ 2014CrossRefPubMed Preiss JC, Bokemeyer B, Buhr HJ, Dignass A, Hauser W, Hartmann F et al. [Updated German clinical practice guideline on „Diagnosis and treatment of Crohn’s disease“ 2014]. Zeitschrift fur Gastroenterologie. 2014;52(12):1431–84. Epub 2014/12/05. Aktualisierte S3-Leitlinie“Diagnostik und Therapie des Morbus Crohn“ 2014CrossRefPubMed
11.
Zurück zum Zitat Dignass A, Preiss JC, Aust DE, Autschbach F, Ballauff A, Barretton G et al. Updated German guideline on diagnosis and treatment of ulcerative colitis, 2011. Zeitschrift fur Gastroenterologie. 2011;49(9):1276–341. Epub 2011/08/26CrossRefPubMed Dignass A, Preiss JC, Aust DE, Autschbach F, Ballauff A, Barretton G et al. Updated German guideline on diagnosis and treatment of ulcerative colitis, 2011. Zeitschrift fur Gastroenterologie. 2011;49(9):1276–341. Epub 2011/08/26CrossRefPubMed
12.
Zurück zum Zitat Travis SP, Danese S, Kupcinskas L, Alexeeva O, D’Haens G, Gibson PR et al. Once-daily budesonide MMX in active, mild-to-moderate ulcerative colitis: results from the randomised CORE II study. Gut. 2014;63(3):433–41. Epub 2013/02/26CrossRefPubMed Travis SP, Danese S, Kupcinskas L, Alexeeva O, D’Haens G, Gibson PR et al. Once-daily budesonide MMX in active, mild-to-moderate ulcerative colitis: results from the randomised CORE II study. Gut. 2014;63(3):433–41. Epub 2013/02/26CrossRefPubMed
13.
Zurück zum Zitat Panes J, Lopez-Sanroman A, Bermejo F, Garcia-Sanchez V, Esteve M, Torres Y et al. Early azathioprine therapy is no more effective than placebo for newly diagnosed Crohn’s disease. Gastroenterology. 2013;145(4):766–74 e1. Epub 2013/06/19CrossRefPubMed Panes J, Lopez-Sanroman A, Bermejo F, Garcia-Sanchez V, Esteve M, Torres Y et al. Early azathioprine therapy is no more effective than placebo for newly diagnosed Crohn’s disease. Gastroenterology. 2013;145(4):766–74 e1. Epub 2013/06/19CrossRefPubMed
14.
Zurück zum Zitat Cosnes J, Bourrier A, Laharie D, Nahon S, Bouhnik Y, Carbonnel F et al. Early administration of azathioprine vs conventional management of Crohn’s Disease: a randomized controlled trial. Gastroenterology. 2013;145(4):758–65 e2; quiz e14–5. Epub 2013/05/07CrossRefPubMed Cosnes J, Bourrier A, Laharie D, Nahon S, Bouhnik Y, Carbonnel F et al. Early administration of azathioprine vs conventional management of Crohn’s Disease: a randomized controlled trial. Gastroenterology. 2013;145(4):758–65 e2; quiz e14–5. Epub 2013/05/07CrossRefPubMed
15.
Zurück zum Zitat Beaugerie L, Brousse N, Bouvier AM, Colombel JF, Lemann M, Cosnes J et al. Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study. Lancet. 2009;374(9701):1617–25. Epub 2009/10/20CrossRefPubMed Beaugerie L, Brousse N, Bouvier AM, Colombel JF, Lemann M, Cosnes J et al. Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study. Lancet. 2009;374(9701):1617–25. Epub 2009/10/20CrossRefPubMed
16.
Zurück zum Zitat Long MD, Martin CF, Pipkin CA, Herfarth HH, Sandler RS, Kappelman MD. Risk of melanoma and nonmelanoma skin cancer among patients with inflammatory bowel disease. Gastroenterology. 2012;143(2):390–9 e1. Epub 2012/05/16CrossRefPubMedPubMedCentral Long MD, Martin CF, Pipkin CA, Herfarth HH, Sandler RS, Kappelman MD. Risk of melanoma and nonmelanoma skin cancer among patients with inflammatory bowel disease. Gastroenterology. 2012;143(2):390–9 e1. Epub 2012/05/16CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Colombel JF, Sandborn WJ, Reinisch W, Mantzaris GJ, Kornbluth A, Rachmilewitz D et al. Infliximab, azathioprine, or combination therapy for Crohn’s disease. The New England journal of medicine. 2010;362(15):1383–95. Epub 2010/04/16CrossRefPubMed Colombel JF, Sandborn WJ, Reinisch W, Mantzaris GJ, Kornbluth A, Rachmilewitz D et al. Infliximab, azathioprine, or combination therapy for Crohn’s disease. The New England journal of medicine. 2010;362(15):1383–95. Epub 2010/04/16CrossRefPubMed
18.
Zurück zum Zitat Panaccione R, Ghosh S, Middleton S, Marquez JR, Scott BB, Flint L et al. Combination therapy with infliximab and azathioprine is superior to monotherapy with either agent in ulcerative colitis. Gastroenterology. 2014;146(2):392–400 e3. Epub 2014/02/12CrossRefPubMed Panaccione R, Ghosh S, Middleton S, Marquez JR, Scott BB, Flint L et al. Combination therapy with infliximab and azathioprine is superior to monotherapy with either agent in ulcerative colitis. Gastroenterology. 2014;146(2):392–400 e3. Epub 2014/02/12CrossRefPubMed
19.
Zurück zum Zitat Feagan BG, McDonald JW, Panaccione R, Enns RA, Bernstein CN, Ponich TP et al. Methotrexate in combination with infliximab is no more effective than infliximab alone in patients with Crohn’s disease. Gastroenterology. 2014;146(3):681–8 e1. Epub 2013/11/26CrossRefPubMed Feagan BG, McDonald JW, Panaccione R, Enns RA, Bernstein CN, Ponich TP et al. Methotrexate in combination with infliximab is no more effective than infliximab alone in patients with Crohn’s disease. Gastroenterology. 2014;146(3):681–8 e1. Epub 2013/11/26CrossRefPubMed
20.
Zurück zum Zitat Louis E, Mary JY, Vernier-Massouille G, Grimaud JC, Bouhnik Y, Laharie D et al. Maintenance of remission among patients with Crohn’s disease on antimetabolite therapy after infliximab therapy is stopped. Gastroenterology. 2012;142(1):63–70 e5; quiz e31. Epub 2011/09/29CrossRefPubMed Louis E, Mary JY, Vernier-Massouille G, Grimaud JC, Bouhnik Y, Laharie D et al. Maintenance of remission among patients with Crohn’s disease on antimetabolite therapy after infliximab therapy is stopped. Gastroenterology. 2012;142(1):63–70 e5; quiz e31. Epub 2011/09/29CrossRefPubMed
21.
Zurück zum Zitat Brandse JF, van den Brink GR, Wildenberg ME, van der Kleij D, Rispens T, Jansen JM et al. Loss of Infliximab Into Feces Is Associated With Lack of Response to Therapy in Patients With Severe Ulcerative Colitis. Gastroenterology. 2015;149(2):350–5 e2. Epub 2015/04/29CrossRefPubMed Brandse JF, van den Brink GR, Wildenberg ME, van der Kleij D, Rispens T, Jansen JM et al. Loss of Infliximab Into Feces Is Associated With Lack of Response to Therapy in Patients With Severe Ulcerative Colitis. Gastroenterology. 2015;149(2):350–5 e2. Epub 2015/04/29CrossRefPubMed
22.
Zurück zum Zitat Ben-Horin S, Chowers Y. Review article: loss of response to anti-TNF treatments in Crohn’s disease. Alimentary pharmacology & therapeutics. 2011;33(9):987–95. Epub 2011/03/04CrossRef Ben-Horin S, Chowers Y. Review article: loss of response to anti-TNF treatments in Crohn’s disease. Alimentary pharmacology & therapeutics. 2011;33(9):987–95. Epub 2011/03/04CrossRef
23.
Zurück zum Zitat Sandborn WJ, Feagan BG, Marano C, Zhang H, Strauss R, Johanns J et al. Subcutaneous golimumab maintains clinical response in patients with moderate-to-severe ulcerative colitis. Gastroenterology. 2014;146(1):96–109 e1. Epub 2013/06/19CrossRefPubMed Sandborn WJ, Feagan BG, Marano C, Zhang H, Strauss R, Johanns J et al. Subcutaneous golimumab maintains clinical response in patients with moderate-to-severe ulcerative colitis. Gastroenterology. 2014;146(1):96–109 e1. Epub 2013/06/19CrossRefPubMed
24.
Zurück zum Zitat Park W, Hrycaj P, Jeka S, Kovalenko V, Lysenko G, Miranda P et al. A randomised, double-blind, multicentre, parallel-group, prospective study comparing the pharmacokinetics, safety, and efficacy of CT-P13 and innovator infliximab in patients with ankylosing spondylitis: the PLANETAS study. Annals of the rheumatic diseases. 2013;72(10):1605–12. Epub 2013/05/21CrossRefPubMedPubMedCentral Park W, Hrycaj P, Jeka S, Kovalenko V, Lysenko G, Miranda P et al. A randomised, double-blind, multicentre, parallel-group, prospective study comparing the pharmacokinetics, safety, and efficacy of CT-P13 and innovator infliximab in patients with ankylosing spondylitis: the PLANETAS study. Annals of the rheumatic diseases. 2013;72(10):1605–12. Epub 2013/05/21CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Yoo DH, Hrycaj P, Miranda P, Ramiterre E, Piotrowski M, Shevchuk S et al. A randomised, double-blind, parallel-group study to demonstrate equivalence in efficacy and safety of CT-P13 compared with innovator infliximab when coadministered with methotrexate in patients with active rheumatoid arthritis: the PLANETRA study. Annals of the rheumatic diseases. 2013;72(10):1613–20. Epub 2013/05/21CrossRefPubMedPubMedCentral Yoo DH, Hrycaj P, Miranda P, Ramiterre E, Piotrowski M, Shevchuk S et al. A randomised, double-blind, parallel-group study to demonstrate equivalence in efficacy and safety of CT-P13 compared with innovator infliximab when coadministered with methotrexate in patients with active rheumatoid arthritis: the PLANETRA study. Annals of the rheumatic diseases. 2013;72(10):1613–20. Epub 2013/05/21CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Gecse KB, Lovasz BD, Farkas K, Banai J, Bene L, Gasztonyi B et al. Efficacy and Safety of the Biosimilar Infliximab CT-P13 Treatment in Inflammatory Bowel Diseases: A Prospective, Multicentre, Nationwide Cohort. Journal of Crohn’s & colitis. 2016;10(2):133–40. Epub 2015/12/15CrossRef Gecse KB, Lovasz BD, Farkas K, Banai J, Bene L, Gasztonyi B et al. Efficacy and Safety of the Biosimilar Infliximab CT-P13 Treatment in Inflammatory Bowel Diseases: A Prospective, Multicentre, Nationwide Cohort. Journal of Crohn’s & colitis. 2016;10(2):133–40. Epub 2015/12/15CrossRef
27.
Zurück zum Zitat Sandborn WJ, Feagan BG, Rutgeerts P, Hanauer S, Colombel JF, Sands BE et al. Vedolizumab as induction and maintenance therapy for Crohn’s disease. The New England journal of medicine. 2013;369(8):711–21. Epub 2013/08/24CrossRefPubMed Sandborn WJ, Feagan BG, Rutgeerts P, Hanauer S, Colombel JF, Sands BE et al. Vedolizumab as induction and maintenance therapy for Crohn’s disease. The New England journal of medicine. 2013;369(8):711–21. Epub 2013/08/24CrossRefPubMed
28.
Zurück zum Zitat Feagan BG, Rutgeerts P, Sands BE, Hanauer S, Colombel JF, Sandborn WJ et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. The New England journal of medicine. 2013;369(8):699–710. Epub 2013/08/24CrossRefPubMed Feagan BG, Rutgeerts P, Sands BE, Hanauer S, Colombel JF, Sandborn WJ et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. The New England journal of medicine. 2013;369(8):699–710. Epub 2013/08/24CrossRefPubMed
29.
Zurück zum Zitat De Cruz P, Kamm MA, Hamilton AL, Ritchie KJ, Krejany EO, Gorelik A et al. Crohn’s disease management after intestinal resection: a randomised trial. Lancet. 2015;385(9976):1406–17. Epub 2014/12/30CrossRefPubMed De Cruz P, Kamm MA, Hamilton AL, Ritchie KJ, Krejany EO, Gorelik A et al. Crohn’s disease management after intestinal resection: a randomised trial. Lancet. 2015;385(9976):1406–17. Epub 2014/12/30CrossRefPubMed
30.
Zurück zum Zitat Khanna R, Bressler B, Levesque BG, Zou G, Stitt LW, Greenberg GR et al. Early combined immunosuppression for the management of Crohn’s disease (REACT): a cluster randomised controlled trial. Lancet. 2015;386(10006):1825–34. Epub 2015/09/08CrossRefPubMed Khanna R, Bressler B, Levesque BG, Zou G, Stitt LW, Greenberg GR et al. Early combined immunosuppression for the management of Crohn’s disease (REACT): a cluster randomised controlled trial. Lancet. 2015;386(10006):1825–34. Epub 2015/09/08CrossRefPubMed
31.
Zurück zum Zitat Williet N, Sandborn WJ, Peyrin-Biroulet L. Patient-reported outcomes as primary end points in clinical trials of inflammatory bowel disease. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2014;12(8):1246–56 e6. Epub 2014/02/19CrossRef Williet N, Sandborn WJ, Peyrin-Biroulet L. Patient-reported outcomes as primary end points in clinical trials of inflammatory bowel disease. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2014;12(8):1246–56 e6. Epub 2014/02/19CrossRef
Metadaten
Titel
Update 2016
Das können Sie heute für CED-Patienten tun
verfasst von
Prof. Dr. med. Torsten Kucharzik
Publikationsdatum
08.11.2016
Verlag
Springer Medizin
Erschienen in
MMW - Fortschritte der Medizin / Ausgabe Sonderheft 3/2016
Print ISSN: 1438-3276
Elektronische ISSN: 1613-3560
DOI
https://doi.org/10.1007/s15006-016-8234-9

Weitere Artikel der Sonderheft 3/2016

MMW - Fortschritte der Medizin 3/2016 Zur Ausgabe

FORTBILDUNG . KRITISCH GELESEN

Verdächtiges Ulkus an der Ferse

Kurz notiert

Akute Pharyngitis

Magen-Darm-Erkrankungen in der Hausarztpraxis

Häufige gastrointestinale Krankheiten in der niedergelassenen Praxis sind Thema in diesem aufgezeichneten MMW-Webinar. Welche Differenzialdiagnosen bei Oberbauchbeschwerden sollten Sie kennen? Wie gelingt eine erfolgreiche probiotische Behandlung bei Reizdarm? Welche neuen Entwicklungen und praktischen Aspekte gibt es bei Diagnostik und Behandlung der chronisch entzündlichen Darmerkrankungen?