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22.10.2019 | Methotrexat | Schwerpunkt

Optimierung der konservativen (Nichtbiologika‑)Therapie bei chronisch-entzündlichen Darmerkrankungen

verfasst von: Prof. E. F. Stange, Prof. Dr. K. Herrlinger

Erschienen in: Die Gastroenterologie | Ausgabe 6/2019

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Zusammenfassung

In den Leitlinien der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) zu den chronisch-entzündlichen Darmerkrankungen (CED) Morbus Crohn und Colitis ulcerosa hat das konservative Vorgehen mit Aminosalizylaten, Kortikosteroiden und klassischen Immunsuppressiva wie Thiopurinen und Methotrexat immer noch Vorrang vor dem frühen Einstieg mit sog. Biologika (antikörperbasierte Therapien). Dies ist nicht nur aus Kostengründen sinnvoll, sondern auch wegen des oft blanden Verlaufs beider Erkrankungen und der Möglichkeit einer frühen Therapieeskalation („accelerated step up“) bei kompliziertem Verlauf mit einer effektiven Immunsuppression zur Umgehung einer Steroidlangzeittherapie. Die Ausschöpfung der konservativen Medikamente vermeidet auch die frühe Einschränkung der therapeutischen Optionen durch den nahezu regelhaften Wirkverlust und dann notwendigen Wechsel der wenigen zugelassenen Antikörper.

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Titel: Optimierung der konservativen (Nichtbiologika‑)Therapie bei chronisch-entzündlichen Darmerkrankungen
verfasst von: Prof. E. F. Stange
Prof. Dr. K. Herrlinger
Publikationsdatum: 22.10.2019
Verlag: Springer Medizin
Schlagwörter: Methotrexat
Chronisch-entzündliche Darmerkrankungen
Colitis ulcerosa
Morbus Crohn
Methotrexat
Azathioprin
Infliximab
Budesonid
Azathioprin
Tacrolimus
Erschienen in: Die Gastroenterologie / Ausgabe 6/2019
Print ISSN: 2731-7420
Elektronische ISSN: 2731-7439
DOI: https://doi.org/10.1007/s11377-019-00386-x

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