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Therapie chronisch-entzündlicher Darmerkrankungen

Standards, Kontroversen und Perspektiven

Therapy of chronic inflammatory bowel diseases

Standards, controversies and perspectives

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Zusammenfassung

Morbus Crohn und Colitis ulcerosa sind die häufigsten chronisch-entzündlichen Darmerkrankungen. Ihre Behandlung wird zunehmend komplex und gerade bei komplizierten Krankheitsverläufen auch individualisierter. Dieser Beitrag gibt einen umfassenden Überblick über die Verlaufsformen und die Standardtherapie beider Erkrankungen. Weiterhin wird auf aktuelle Kontroversen wie die frühe Immunsuppression und Immunmodulation, aber auch auf neue Therapieziele wie die Mukosaheilung eingegangen. Schließlich wird ein Ausblick auf zukünftige Therapieoptionen gegeben. Hier steht insbesondere Vedolizumab, ein Antikörper gegen das darmspezifische α4β7-Integrin, im Fokus.

Abstract

Crohn’s disease and ulcerative colitis are the most common forms of chronic inflammatory bowel disease. The therapeutic algorithm is complex and individualized especially in complicated courses of the disease. This article gives a comprehensive overview on the typical courses of disease and the standard therapy of both diseases. Furthermore, ongoing controversies will be highlighted including early immunosuppression and immunomodulation as well as new therapeutic goals, such as mucosal healing. Finally, a perspective on future therapeutic options is given focusing especially on vedolizumab, the new antibody against the bowel-specific α4β7-integrin.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. K. Herrlinger: Vortragshonorare von Falk Pharma, AbbVie. Beratung von MSD. K. Fellermann: Vortragshonorare von Falk Pharma, AbbVie, Roche und Shire. E.F. Stange: Vortragshonorare von Falk Pharma, AbbVie, Ferring und Ardeypharm. Beratung von Merck und Takeda. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Abteilung Innere Medizin 1, Asklepios Klinik Nord, Standort Heidberg, Tangstedter Landstr. 400, 22417, Hamburg, Deutschland

    K. Herrlinger

  2. Medizinische Klinik I, Bereich Gastroenterologie und Hepatologie, Universitätsklinik Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

    K. Fellermann

  3. Gastroenterologie, Hepatologie und Endokrinologie, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland

    E.F. Stange

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  1. K. Herrlinger
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  2. K. Fellermann
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  3. E.F. Stange
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Correspondence to K. Herrlinger.

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Herrlinger, K., Fellermann, K. & Stange, E. Therapie chronisch-entzündlicher Darmerkrankungen. Internist 55, 906–917 (2014). https://doi.org/10.1007/s00108-013-3442-1

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