Der Gastroenterologe

, Volume 6, Issue 6, pp 486–495 | Cite as

Behandlung chronisch entzündlicher Darmerkrankungen bei Kindern und Jugendlichen

Therapiekonzepte einschließlich Biologika
Schwerpunkt
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Zusammenfassung

Die Behandlung von Kindern und Jugendlichen mit chronisch entzündlichen Darmerkrankungen (CED) ist aufgrund einer schmalen wissenschaftlichen Basis für Therapieentscheidungen nach wie vor problematisch. Daten aus Studien bei Erwachsenen sind mit Vorbehalt zu werten. Biologika (TNF-α-Blocker) haben die CED-Therapie bereichert. Studiendaten zeigen bei Kindern einen steroidsparenden und das Wachstum optimierenden Effekt. Bei Versagen einer Standardtherapie sowie bei extraintestinalem Befall und Fisteln werden TNF-α-Blocker zunehmend primär oder früh im Therapiekonzept eingesetzt. Bei Kindern mit schwerer Colitis ulcerosa sind TNF-α-Blocker trotz fehlender Zulassung eine Alternative zu bisherigen Immunsuppressiva.

Schlüsselwörter

Biologika M. Crohn Colitis ulcerosa TNF-α-Blocker Remission 

Treatment of chronic inflammatory intestinal diseases in children and adolescents

Therapy concepts including biologics

Abstract

The treatment of children and adolescents with chronic inflammatory intestinal diseases is still problematic because of a narrow scientific basis for therapeutic decision-making. Data from studies involving adults must be evaluated with caution. Biologics, such as TNF-α blockers have been approved for the induction and maintenance of remission in moderate-to-severe pediatric Crohn’s disease that is unresponsive to conventional therapy. Data from studies on children show a steroid-saving and growth optimizing effect. Regularly scheduled maintenance therapy is recommended. Inflixmab is also a therapeutic alternative in children with severe ulcerative colitis. Adalimumab may be used in cases of side-effects or loss of response.

Keywords

Biological factors Crohn disease Colitis, ulcerative TNF-alpha blockers Remission 

Notes

Interessenkonflikt

Der Autor weist auf folgende Beziehungen hin: Mitglied im Advisory Board für chronisch entzündliche Darmerkrankungen im Kindesalter der Fa. MSD sowie Referententätigkeit für die Firmen MSD, Falk und Abbott.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Klinik für Kinder- und JugendmedizinKlinikum Ernst von BergmannPotsdamDeutschland

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