Immunsuppression bei chronisch-entzündlichen Darmerkrankungen: Wann, wie und wie lange?

Zusammenfassung

Die immunsuppressive Therapie ist wichtiger Bestandteil der Behandlung von Patienten mit chronisch entzündlicher Darmerkrankung. Therapieziel ist das Erreichen einer langfristigen Remission. Kandidaten für eine immunsuppressive Therapie sind Patienten mit steroidrefraktären akuten Krankheitsschüben, Steroidabhängigkeit , chronisch aktivem Verlauf oder häufigen Rezidiven. Zur Verfügung stehen konventionelle Immunsuppressiva, in erster Linie Azathioprin/6-Mercaptopurin, weiterhin Methotrexat und die Calcineurin-Inhibitoren Cyclosporin A und Tacrolimus sowie die Anti-TNF-Antikörper Infliximab und Adalimumab. Aktuelle Leitlinien setzen den Rahmen für den rationalen Einsatz dieser Medikamente zur Remissionsinduktion und Remissionserhaltung.

Abstract

Immunosuppressive treatment is an important tool in the therapy of patients with inflammatory bowel disease. Treatment goal is a long lasting remission. Candidates for immunosuppressive treatment are patients with steroid-refractory active disease, steroid-dependency, chronic active disease or frequent relapses. Conventional immunosuppressives (azathioprine/6-mercaptopurine, methotrexate, the calcineurin inhibitors cyclosporine A and tacrolimus), and anti-TNF antibodies (infliximab, adalimumab) are available. Current guidelines set the frame for the rational use of these drugs.

Schlüsselwörter

Morbus Crohn - Colitis ulcerosa - Immunsuppressiva - Anti-TNF Antikörper

Keywords

Crohn’s disease - ulcerative colitis - immunosuppressive drugs - anti-TNF antibodies

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