Der Internist

, Volume 51, Issue 12, pp 1492–1498 | Cite as

Was ist gesichert in der Therapie chronisch entzündlicher Darmerkrankungen?

Schwerpunkt
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Zusammenfassung

Die Therapie chronisch entzündlicher Darmerkrankungen richtete sich bislang vorwiegend nach der Klinik: Bei fehlendem Ansprechen wurde die Therapie eskaliert, bis eine klinische Remission erreicht wurde. Die klinische Remission entspricht jedoch nicht einer mukosalen Abheilung. Analog zu den Daten zur rheumatoiden Arthritis zeigen vorliegende Studien, dass eine frühe effektive Behandlung chronisch entzündlicher Darmerkrankungen strukturelle Veränderungen reduzieren kann. In der vorliegenden Übersicht werden Arbeiten diskutiert, die die mukosale Abheilung als mögliches neues Therapieziel definieren. Die Identifikation von Risikofaktoren, die einen komplizierten Verlauf anzeigen, stellt einen ersten Schritt in Richtung einer individuellen Therapie chronisch entzündlicher Darmerkrankungen dar. Entsprechend soll auf Therapiestrategien und die dazugehörige Risikoabwägung eingegangen werden.

Schlüsselwörter

Chronisch entzündliche Darmerkrankungen Mukosale Heilung Therapieeskalation Immunsuppression Präventionsstrategien 

What has been confirmed in the treatment of inflammatory bowel disease?

Abstract

The therapy of inflammatory bowel diseases is currently guided by clinical variables. An escalation of immunosuppressive therapy is required in case of treatment failure. However, clinical remission does not necessarily imply mucosal healing. In parallel to the treatment of rheumatoid arthritis a novel concept is emerging suggesting that an early anti-inflammatory treatment can reduce structural changes in inflammatory bowel diseases. The studies supporting this novel therapeutic strategy that mucosal healing might build the future therapeutic goal will be discussed. In order to adjust the therapy, risk factors indicating a complicated disease course will be identified, resulting in the development of an individual disease course. The benefit of these strategies will be discussed together with therapy-associated complications.

Keywords

Chronic inflammatory bowel diseases Mucosal healing Therapy escalation Immunosuppression Preventive strategies 

Notes

Interessenkonflikt

Frau PD Dr. B. Siegmund war als Referent für die Firmen Abbott, Essex, Shire, Falk und Merckle Recordati tätig und hat Beraterhonorare von den Firmen Abbott und Nycomed erhalten.

Herr Dr. J. Preiß war als Referent für die Firmen Essex und Falk tätig und hat Beraterhonorare von der Firma Essex erhalten.

Herr Prof. Dr. M. Zeitz war als Referent für die Firmen Abbott, Essex, Falk und Merckle Recordati tätig und hat Beraterhonorare der Firmen Abbott, Essex und Shire erhalten.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Medizinische Klinik ICharité – Universitätsmedizin Berlin, Campus Benjamin FranklinBerlinDeutschland

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