Der Internist

, Volume 46, Issue 12, pp 1347–1353 | Cite as

Neue Therapiekonzepte bei Vaskulitiden und Kollagenosen

Schwerpunkt: Was ist gesichert in der Therapie?

Zusammenfassung

Die Prognose der primär systemischen Vaskulitiden und des systemischen Lupus erythematodes hat sich in den letzten Jahrzehnten durch verbesserte Diagnostik und Therapie von einem häufig letalen Verlauf mit einem durchschnittlichen Überleben von weniger als 1 Jahr nach Diagnosestellung zu einer 5-Jahres-Überlebensrate von über 90% verbessert. Derzeit konzentrieren sich die therapeutischen Bemühungen auf die Therapie der therapierefraktären Krankheitsverläufe, d. h. diejenigen Patienten, die durch die derzeitige Standardtherapie nicht in eine Remission zu bringen sind und diejenigen, bei denen die Standardtherapie wegen Organschäden und Kontraindikationen nicht eingesetzt werden kann. Zudem gehen die Bemühungen dahin, weniger toxische Therapieregimes einzusetzen und Sekundärkomplikationen der Standardtherapie zu erkennen und zu vermeiden. Hierfür wurden in den letzten Jahren zunehmend neue Substanzen aus der Rheumatologie, der Transplantationsmedizin und der Hämatologie übernommen. Über die bislang vorliegenden Erfahrungen mit den Substanzen Infliximab, Mycophenolat Mofetil, Rituximab und Deoxyspergualin bei den Kleingefäßvaskulitiden und dem systemischen Lupus erythematodes wird in dieser Übersicht referiert.

Schlüsselwörter

Vaskulitis Kollagenose Primär systemische Vaskulitis Systemischer Lupus erythematodes 

New therapeutic concepts for vasculitis and collagenosis

Abstract

After improvement of the prognosis of the primary systemic vasculitides and systemic lupus erythematosus from a desperate diagnosis with hardly a one year survival after diagnosis to a 5-year-survival-rate of more than 90% actual therapeutic regimes aim at those patients refractory to standard therapeutic regimes, not achieving a remission by standard approaches or having organ damage or contraindications. Furthermore less toxic regimes are looked for with the aim to avoid secondary complications of the standard therapy. New drugs used successfully in rheumatology, transplantation medicine and haematology are used for these purposes in the last years. Recent experiences with Infliximab, Mycophenolate Mofetil, Rituximab und Deoxyspergualin for the treatment of the small vessel vasculitides and systemic lupus erythematosus are reviewed.

Keywords

Vasculitis Collagenosis Primary systemic vasculitis Systemic lupus erythematosus 

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Copyright information

© Springer Medizin Verlag 2005

Authors and Affiliations

  1. 1.Rheumaklinik Bad Bramstedt GmbH & Poliklinik für RheumatologieUniversitätsklinikum Schleswig Holstein, Campus Lübeck
  2. 2.Schwerpunktpraxis Internistische RheumatologieRheumazentrum Elmshorn
  3. 3.Schwerpunktpraxis Internistische RheumatologieRheumazentrumElmshorn

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