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Anti-TNF-Biologika in der Therapie chronisch-entzündlicher Darmerkrankungen

Anti-TNF biologics in the treatment of chronic inflammatory bowel disease

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Zusammenfassung

Die Therapie mit Infliximab für den komplizierten Verlauf des M. Crohn und der Colitis ulcerosa wurde durch große prospektive Therapiestudien in den letzten 10 Jahren etabliert. Mit der Zulassung von Adalimumab besteht nun die Wahl zwischen 2 verschiedenen Biologika für die Anti-Tumor-Nekrose-Faktor- (TNF-)Therapie. Neben der Unterdrückung der Entzündungsaktivität ist die Beendigung einer chronischen Glukokortikoidtherapie ein wichtiger Grund für den Einsatz der Anti-TNF-Therapie geworden. Als neue Indikation zeichnet sich ein früher Einsatz im Krankheitsverlauf ab. Die zunehmend kritische Beobachtung der vorwiegend infektiösen Nebenwirkungen hat einen klaren Trend zur Monotherapie mit Biologika gesetzt.

Abstract

The utility of infliximab as a therapy for complicated inflammatory bowel disease (Crohn’s disease, ulcerative colitis) has been established through large prospective trials in the last decade. With approval of adalimumab physicians and patients now have the choice between two different anti-TNF agents. In addition to control of inflammation, the avoidance of chronic exposure to glucocorticoids has become a primary reason to use anti-TNF therapy. Early use of anti-TNF therapy in the course of disease is a potential new indication. The increasingly critical appreciation of side effects promotes mono-therapy with anti-TNF agents.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Bezahlte Beratertätigkeit bei Abbott Laboratories, Bayer, Berlex/Schering, Boehringer-Ingelheim, Bristol-Myers Squibb, Centocor, Elan Pharmaceuticals, Otsuka, Schering Pharma, Schering-Plough und Essex Pharma, Solvay, Teva, UCB-Celltech und unbezahlte Beratertätigkeit für Chemocentryx. Referententätigkeit für AstraZeneca, Abbott, Essex/Schering-Plough, Falk, Ferring, Genizon, UCB-Celltech, Merckle Recordati und Shire. Erhalt von Forschungsgeldern von AstraZeneca, Berlex/Schering AG, UCB-Celltech und Abbott.

S. Nikolaus: Referententätigkeit für Abbott, Falk, Ferring, Merckle Recordati, Shire und UCB-Celltech.

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  1. Klinik für Allgemeine Innere Medizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Schittenhelm Straße 12, 24105, Kiel, Deutschland

    S. Nikolaus &  S. Schreiber

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  1. S. Nikolaus
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  2. S. Schreiber
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Correspondence to S. Schreiber.

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Nikolaus, S., Schreiber, S. Anti-TNF-Biologika in der Therapie chronisch-entzündlicher Darmerkrankungen. Internist 49, 947–954 (2008). https://doi.org/10.1007/s00108-008-2058-3

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