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Moderne Antirheumatika

Modern disease-modifying antirheumatic drugs

  • Arzneimitteltherapie
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Zusammenfassung

Der Begriff „moderne Antirheumatika“ umfasst nicht nur die ständig wachsende Zahl an neuen Medikamenten zur Behandlung entzündlich-rheumatischer Erkrankungen. Auch etablierte krankheitsmodifizierende Medikamente, die in den Therapiealgorithmen der verschiedenen Krankheitsentitäten neu positioniert werden, fallen darunter. Vorreiter ist in der Regel die rheumatoide Arthritis, zu der die Deutsche Gesellschaft für Rheumatologie kürzlich eine komplett neue S1-Leitlinie erstellt hat. Erweiterungen bestehender Zulassungen gab es auch für Kollagenosen und Vaskulitiden, insbesondere für den Anti-CD20-Antikörper bei ANCA-assoziierten Vaskulitiden und Belimumab für den systemischen Lupus erythematodes. Daneben sind neue antikörperbasierte Wirkstoffe aus der Gruppe der Biologika entweder bereits zugelassen, z. B. Ustekinumab für die Psoriasisarthritis, oder sie befinden sich im Zulassungsprozess, so etwa Granulozytenwachstumshemmer und Janus-Kinase-Hemmer für die rheumatoide Arthritis oder Atacicept für den systemischen Lupus erythematodes. Der Ablauf der ersten Patente für Biologika und die jetzt erfolgende Zulassung von „biosimilars“ bedeuten ein weiteres Momentum – in Bezug auf die Wirk- und Nebenwirkungsäquivalenz sowie den Einfluss auf die zukünftige Preis- und Verordnungsgestaltung ist beides Neuland.

Abstract

The term modern disease-modifying antirheumatic drugs (DMARD) includes not only the constantly growing family of DMARDs for chronic inflammatory rheumatic diseases but also the repositioning of established drugs in updated and novel algorithms of the different entities. The usual precursor for these developments is rheumatoid arthritis for which completely revised and updated guidelines have been published not only in Germany but also on the European level. In addition, label extensions to existing drugs have been granted for connective tissue diseases and vasculitides, e.g. anti-CD20 antibodies for antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitides and belimumab for systemic lupus erythematosus. Moreover, several novel drugs, especially of the biologics class, have been either introduced in clinical rheumatology or are close to being licensed and include ustekinumab for psoriatic arthritis, granulocyte growth inhibitors and janus kinase inhibitors for rheumatoid arthritis and atacicept for systemic lupus erythematosus. With the termination of the patent for several biologics, a new momentum also took place: the approval of the so-called biosimilars which has already initiated intensive discussions not only with respect to “similar” effects and side effects but also with respect to their potential impact on economical aspects.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. U. Müller-Ladner: Referenten-/Beraterhonorare von den Firmen Medoc, MSD, BMS, AbbVie, Pfizer, Roche, Chugai, Janssen, Berlin-Chemie. K. Richter: Referentenhonorar von der Firma Pfizer. I.H. Tarner: Referentenhonorar der Firmen Pfizer, Roche, Chugai, AbbVie, Janssen.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie, Abteilung für Rheumatologie und Klinische Immunologie, Justus-Liebig-Universität Gießen, Kerckhoff-Klinik GmbH, Benekestr. 2–8, 61231, Bad Nauheim, Deutschland

    U. Müller-Ladner, K. Richter & I.H. Tarner

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  1. U. Müller-Ladner
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  2. K. Richter
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  3. I.H. Tarner
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Correspondence to U. Müller-Ladner.

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Müller-Ladner, U., Richter, K. & Tarner, I. Moderne Antirheumatika. Internist 56, 307–314 (2015). https://doi.org/10.1007/s00108-014-3651-2

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  • DOI: https://doi.org/10.1007/s00108-014-3651-2

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