Zusammenfassung
Lange Zeit gab es in der Medikamentenentwicklung der Colitis ulcerosa (CU) im Anschluss an die Einführung der TNF-Hemmer keine wegweisenden Neuerungen. Dies hat sich seit der Zulassung des ersten Integrinhemmers Vedolizumab im Jahr 2014 geändert. Eine beachtliche Dynamik ist entstanden, was sich auch in einer mittlerweile kaum mehr zu übersehenden Anzahl von Therapiestudien für verschiedene Substanzgruppen niederschlägt. Die traditionelle Pyramide der Medikamententherapie – mit 5-Aminosalicylsäure als Basis, darüber Steroide, anschließend Thiopurine und TNF-Hemmer in der dünnen Spitze – wird nun durch die zahlreichen Neuerungen in den Therapieoptionen und deren Positionierung zunehmend infrage gestellt. Allerdings ist der definitive Platz der neueren Substanzen im Therapiealgorithmus noch genauer zu bestimmen und derzeit nicht eindeutig klar. Es zeichnet sich jedoch ab, dass die Therapie der CU komplexer wird. Es ist davon auszugehen, dass zukünftig auch verschiedene Optionen einer Kombinationstherapie geprüft werden müssen, wie es sich in diversen anderen Feldern der Medizin als sinnvoll erwiesen hat. Betrachtet man diese neuen Substanzen genauer, fällt auf, dass sich diverse Überlappungen mit anderen Disziplinen im Bereich der immunmediierten Erkrankungen ergeben, insbesondere der Rheumatologie, Dermatologie, aber auch Neurologie und klinischen Immunologie. Da in diesen Disziplinen einige der neuen Substanzen für andere Indikationen bereits länger zugelassen sind, ergeben sich hier wichtige Informationen hinsichtlich Nebenwirkungen und Sicherheit. Im Gegensatz zu den Informationen zu Nebenwirkungen haben die bisherigen Erfahrungen gezeigt, dass sich Effektivitätsdaten zum Beispiel aus der Rheumatologie nur sehr begrenzt auf chronisch-entzündliche Darmerkrankungen übertragen lassen. Im Folgenden werden die einzelnen Substanzklassen in Kürze dargestellt.
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Adedokun OJ, Sandborn WJ, Feagan BG, Rutgeerts P, Xu Z, Marano CW et al (2014) Association between serum concentration of infliximab and efficacy in adult patients with ulcerative colitis. Gastroenterology 147(6) 1296–1307. https://doi.org/10.1053/j.gastro.2014.08.035
Adedokun OJ, Xu Z, Marano CW, Strauss R, Zhang H, Johanns J et al (2017) Pharmacokinetics and exposure-response relationship of golimumab in patients with moderately-to-severely active ulcerative colitis: results from Phase 2/3 PURSUIT induction and maintenance studies. J Crohns Colitis 11(1):35–46. https://doi.org/10.1093/ecco-jcc/jjw133
Ananthakrishnan AN, Cheng S–C, Cai T, Cagan A, Gainer, Vivian S, Szolovits P et al (2014) Association between reduced plasma 25-hydroxy vitamin D and increased risk of cancer in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol 12(5):821–827 https://doi.org/10.1016/j.cgh.2013.10.011
Angelberger S, Reinisch W, Makristathis A, Lichtenberger C, Dejaco C, Papay P et al (2013) Temporal bacterial community dynamics vary among ulcerative colitis patients after fecal microbiota transplantation. Am J Gastroenterol 108(10):1620–1630. http://dx.doi.org/10.1038/ajg.2013.257
Ardizzone S, Maconi G, Russo A, Imbesi V, Colombo E, Bianchi Porro G (2006) Randomised controlled trial of azathioprine and 5-aminosalicylic acid for treatment of steroid dependent ulcerative colitis. Gut 55(1):47–53. https://doi.org/10.1136/gut.2005.068809
Bär F, Kühbacher T, Dietrich NA, Krause T, Stallmach A, Teich N et al (2018) Vedolizumab in the treatment of chronic, antibiotic-dependent or refractory pouchitis. Aliment Pharmacol Ther 47(5):581–587. https://doi.org/10.1111/apt.14479
Baron JH, Connell AM, Lennard-Jones JE, Jones FA (1962) Sulphasalazine and salicylazosulphadimidine in ulcerative colitis. Lancet (London, England) 1(7239):1094–1096
Barreiro-de Acosta M, García-Bosch O, Gordillo J, Mañosa M, Menchén L, Souto R, Marin-Jimenez I (2012) Efficacy of adalimumab rescue therapy in patients with chronic refractory pouchitis previously treated with infliximab: a case series. In: Eur J Gastroenterol Hepatol 24(7):756–758 https://doi.org/10.1097/meg.0b013e3283525a7b
Beaugerie L, Brousse N, Bouvier AM, Colombel JF, Lémann M, Cosnes J et al (2009) Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study. Lancet 374(9701):1617–1625 https://doi.org/10.1016/s0140-6736(09)61302-7
Beaugerie L, Itzkowitz SH (2015) Cancers complicating inflammatory bowel disease. N Engl J Med 372(15):1441–1452. https://doi.org/10.1056/NEJMra1403718
Beaugerie L, Svrcek M, Seksik P, Bouvier A-M, Simon T, Allez M et al (2013) Risk of colorectal high-grade dysplasia and cancer in a prospective observational cohort of patients with inflammatory bowel disease. Gastroenterology http://linkinghub.elsevier.com/retrieve/pii/S0016508513004587?showall=true
Biedermann L, Mwinyi J, Scharl M, Frei P, Zeitz J, Kullak-Ublick GA et al (2013) Bilberry ingestion improves disease activity in mild to moderate ulcerative colitis – an open pilot study. J Crohns Colitis 7(4):271–279. https://doi.org/10.1016/j.crohns.2012.07.010
Bonovas S, Fiorino G, Lytras T, Nikolopoulos G, Peyrin-Biroulet L, Danese S (2017) Systematic review with meta-analysis. Use of 5-aminosalicylates and risk of colorectal neoplasia in patients with inflammatory bowel disease. Aliment Pharmacol Ther 45(9):1179–1192 https://doi.org/10.1111/apt.14023
Brandse JF, Mathôt RA, van der Kleij D, Rispens T, Ashruf Y, Jansen JM et al (2016) Pharmacokinetic features and presence of antidrug antibodies associate with response to infliximab induction therapy in patients with moderate to severe ulcerative colitis. Clin Gastroenterol Hepatol 14(2):251. https://doi.org/10.1016/j.cgh.2015.10.029
Campieri M, Corbelli C, Gionchetti P, Brignola C, Belluzzi A, Di Febo G et al (1992) Spread and distribution of 5-ASA colonic foam and 5-ASA enema in patients with ulcerative colitis. Dig Dis Sci 37(12):1890–1897
Caprilli R, Cesarini M, Angelucci E, Frieri G (2009) The long journey of salicylates in ulcerative colitis: the past and the future. J Crohns Colitis 3(3):149–156. https://doi.org/10.1016/j.crohns.2009.05.001
Carbonnel F, Colombel JF, Filippi J, Katsanos KH, Peyrin-Biroulet L, Allez M et al (2016) Methotrexate is not superior to placebo for inducing steroid-free remission, but induces steroid-free clinical remission in a larger proportion of patients with ulcerative colitis. Gastroenterol 150(2):380–388.e4. https://doi.org/10.1053/j.gastro.2015.10.050
Chaparro M, Burgueño P, Iglesias E, Panés J, Muñoz F, Bastida G et al (2012) Infliximab salvage therapy after failure of ciclosporin in corticosteroid-refractory ulcerative colitis: a multicentre study. Aliment Pharmacol Ther 35(2):275–283. https://doi.org/10.1111/j.1365-2036.2011.04934.x
Christensen B, Gibson P, Micic D, Colman RJ, Goeppinger SR, Kassim O et al (2018) Safety and efficacy of combination treatment with calcineurin inhibitors and vedolizumab in patients with refractory inflammatory bowel disease. Clinical gastroenterol hepatol: the official clinical practice journal of the American Gastroenterological Association. https://doi.org/10.1016/j.cgh.2018.04.060
Christophorou D, Funakoshi N, Duny Y, Valats J-C, Bismuth M., Pineton De Chambrun G et al (2015) Systematic review with meta-analysis: infliximab and immunosuppressant therapy vs. infliximab alone for active ulcerative colitis. Aliment Pharmacol Ther 41(7):603–612. https://doi.org/10.1111/apt.13102
Colombel J-F, Ricart E, Loftus EV, JR, Tremaine WJ, Young-Fadok T, Dozois EJ et al (2003) Management of Crohn’s disease of the ileoanal pouch with infliximab. Am J Gastroenterol 98(10):2239–2244. https://doi.org/10.1111/j.1572-0241.2003.07675.x
Colombel J-F, Sands BE, Rutgeerts P, Sandborn W, Danese S, D’Haens G et al (2015) The safety of vedolizumab for ulcerative colitis and Crohn’s disease. Gut, gutjnl-2015-311079. https://doi.org/10.1136/gutjnl-2015-311079
Danese S, Neurath M, Kopon A, Zakko S, Simmons T, Fogel R et al (2018) OP006 Apremilast for active ulcerative colitis: a phase 2, randomised, double-blind, placebo-controlled induction study. Abstracts of the 8th Congress of ECCO – the European Crohn’s and Colitis Organisation 12 (1):S004–S005. https://doi.org/10.1093/ecco-jcc/jjx180.004
Danese S, Grisham M, Hodge J, Telliez J-B (2016) JAK inhibition using tofacitinib for inflammatory bowel disease treatment: a hub for multiple inflammatory cytokines. Am J physiol Gastrointest liver physiol 310(3):G155–62. https://doi.org/10.1152/ajpgi.00311.2015
Dulai PS, Singh S, Casteele NV, Boland BS, Sandborn WJ (2016a) How will evolving future therapies and strategies change how we position the use of biologics in moderate to severely active inflammatory bowel disease. Inflamm Bowel Dis 22(4):998–1009. https://doi.org/10.1097/MIB.0000000000000661
Dulai, PS, Singh S, Jiang X, Peerani F, Narula N, Chaudrey K et al (2016b) The real-world effectiveness and safety of Vedolizumab for moderate-severe Crohn’s disease: results from the US VICTORY consortium. Am J Gastroenterol. https://doi.org/10.1038/ajg.2016.236
Faubion WA, Loftus EV, Harmsen WS, Zinsmeister AR, Sandborn WJ (2001) The natural history of corticosteroid therapy for inflammatory bowel disease: a population-based study. Gastroenterology 121(2):255–260
Feagan BG, Rutgeerts P, Sands BE, Hanauer S, Colombel J-F, Sandborn WJ et al (2013) Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 369(8):699–710. https://doi.org/10.1056/NEJMoa1215734
Fedyk ER, Wyant T, Yang L-L, Csizmadia V, Burke K, Yang H, Kadambi VJ (2012) Exclusive antagonism of the α4β7 integrin by vedolizumab confirms the gut-selectivity of this pathway in primates. Inflamm Bowel Dis 18(11):2107–2119. https://doi.org/10.1002/ibd.22940
Fernández-Bañares F, Hinojosa J, Sánchez-Lombraña JL, Navarro E, Martínez-Salmerón JF, García-Pugés A et al (1999) Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn’s Disease and Ulcerative Colitis (GETECCU). Am J Gastroenterol 94(2):427–433. https://doi.org/10.1111/j.1572-0241.1999.872_a.x
Ford AC, Khan KJ, Achkar J-P, Moayyedi P (2012) Efficacy of oral vs. topical, or combined oral and topical 5-aminosalicylates, in ulcerative colitis: systematic review and meta-analysis. Am J Gastroenterol 107(2):167–176. https://doi.org/10.1038/ajg.2011.410
Fraser AG, Orchard TR, Jewell DP (2002) The efficacy of azathioprine for the treatment of inflammatory bowel disease: a 30 year review. Gut 50(4):485–489
Frei P, Biedermann L, Manser CN, Wilk M, Manz M, Vavricka SR, Rogler G (2012) Topical therapies in inflammatory bowel disease. Digestion 86 (Suppl. 1):36–44. http://www.karger.com/DOI/10.1159/000341947
Frei P, Biedermann L, Nielsen OH, Rogler G (2013) Use of thiopurines in inflammatory bowel disease. World J Gastroenterol 19(7):1040–1048. https://doi.org/10.3748/wjg.v19.i7.1040
Garg M, Hendy P, Ding JN, Shaw S, Hold G, Hart A (2018) The effect of vitamin D on intestinal inflammation and faecal microbiota in patients with ulcerative colitis. J Crohn’s & colitis 12(8):963–972. https://doi.org/10.1093/ecco-jcc/jjy052
Gibson DJ, Heetun ZS, Redmond CE, Nanda KS, Keegan D, Byrne K et al (2014) An accelerated infliximab induction regimen reduces the need for early colectomy in patients with acute severe ulcerative colitis. Clin Gastroenterol Hepatol. https://doi.org/10.1016/j.cgh.2014.07.041
Gionchetti P, Rizzello F, Poggioli G, Pierangeli F, Laureti S, Morselli C et al (2007) Oral budesonide in the treatment of chronic refractory pouchitis. Aliment Pharmacol Ther 25(10):1231–1236. https://doi.org/10.1111/j.1365-2036.2007.03306.x
Gionchetti P, Carlo C, Calafiore A, Praticò C, Poggioli G, Laureti S et al (2014) Oral beclomethasone dipropionate in chronic refractory pouchitis. J Crohns Colitis 8(7):649–653. https://doi.org/10.1016/j.crohns.2013.12.001
Gisbert JP, González-Lama Y, Maté J (2007) 5-Aminosalicylates and renal function in inflammatory bowel disease: a systematic review. Inflamm Bowel Dis 13(5):629–638. https://doi.org/10.1002/ibd.20099
Glück T, Kiefmann B, Grohmann M, Falk W, Straub RH, Schölmerich J (2005) Immune status and risk for infection in patients receiving chronic immunosuppressive therapy. J Rheumatol 32(8):1473–1480
Greuter T, Biedermann L, Rogler G, Sauter B, Seibold F (2016) Alicaforsen, an antisense inhibitor of ICAM-1, as treatment for chronic refractory pouchitis after proctocolectomy: a case series. Unit Eur Gastroenterol J 4(1):97–104. https://doi.org/10.1177/2050640615593681
Gross V, Bar-Meir S, Lavy A, Mickisch O, Tulassay Z, Pronai L et al (2006) Budesonide foam versus budesonide enema in active ulcerative proctitis and proctosigmoiditis. Aliment Pharmacol Ther 23(2):303–312. https://doi.org/10.1111/j.1365-2036.2006.02743.x
Harbord M, Eliakim R, Bettenworth D, Karmiris K, Katsanos K, Kopylov U et al (2017) Third european evidence-based consensus on diagnosis and management of ulcerative colitis. Part 2. Current Management. J Crohns Colitis 11(7):769–784. https://doi.org/10.1093/ecco-jcc/jjx009
Harris MS, Hartman D, Lemos BR, Erlich EC, Spence S, Kennedy S et al (2016) AVX-470, an orally delivered anti-tumour necrosis factor antibody for treatment of active ulcerative colitis: results of a first-in-human trial. Journal of Crohn’s & colitis 10(6):631–640. https://doi.org/10.1093/ecco-jcc/jjw036
Hawthorne AB, Logan RF, Hawkey CJ, Foster PN, Axon AT, Swarbrick ET et al (1992) Randomised controlled trial of azathioprine withdrawal in ulcerative colitis. BMJ 305(6844):20–22
Herfarth H, Barnes EL, Valentine JF, Hanson J, Higgins P, Isaacs KL et al (2018) Methotrexate is not superior to placebo in maintaining steroid-free response or remission in ulcerative colitis. Gastroenterology https://doi.org/10.1053/j.gastro.2018.06.046
Herfarth HH, Long MD, Isaacs KL (2012) Methotrexate: underused and ignored? Dig Dis 30(Suppl 3):112–118. https://doi.org/10.1159/000342735
Herfarth HH, Rogler G, Higgins PDR (2014) Pushing the pedal to the metal: should we accelerate infliximab therapy for patients with severe ulcerative colitis? Clin Gastroenterol Hepatol: the official clinical practice journal of the American Gastroenterological Association. https://doi.org/10.1016/j.cgh.2014.09.045
Hilsden RJ, Verhoef MJ, Best A, Pocobelli G (2003) Complementary and alternative medicine use by Canadian patients with inflammatory bowel disease: results from a national survey. Am J Gastroenterol 98(7):1563–1568. https://doi.org/10.1111/j.1572-0241.2003.07519.x
Hoentjen F, Seinen ML, Hanauer SB, de Boer NKH, Rubin DT, Bouma G et al (2013) Safety and effectiveness of long-term allopurinol-thiopurine maintenance treatment in inflammatory bowel disease. Inflamm Bowel Dis 19(2):363–369. https://doi.org/10.1002/ibd.23021
Jewell DP, Truelove SC (1972) Azathioprine in ulcerative colitis. Gut 13(4):323
Kabbani TA, Koutroubakis IE, Schoen RE, Ramos-Rivers C, Shah N, Swoger J et al (2016) Association of vitamin d level with clinical status in inflammatory bowel disease: a 5-year longitudinal study. Am J Gastroenterol 111(5):712–719. https://doi.org/10.1038/ajg.2016.53
Kamm MA, Sandborn WJ, Gassull M, Schreiber S, Jackowski L, Butler T et al (2007) Once-daily, high-concentration MMX mesalamine in active ulcerative colitis. Gastroenterology 132(1):66. https://doi.org/10.1053/j.gastro.2006.10.011
Kennedy NA, Rhatigan E, Arnott IDR, Noble CL, Shand AG, Satsangi J, Lees CW (2013) A trial of mercaptopurine is a safe strategy in patients with inflammatory bowel disease intolerant to azathioprine: an observational study, systematic review and meta-analysis. Aliment Pharmacol Ther 38(10):1255–1266. https://doi.org/10.1111/apt.12511
Kirchgesner J, Lemaitre M, Carrat F, Zureik M, Carbonnel MDF, Dray-Spira R (2018) Risk of serious and opportunistic infections associated with treatment of inflammatory bowel diseases. Gastroenterology https://doi.org/10.1053/j.gastro.2018.04.012
Kruis W, Fric P, Pokrotnieks J, Lukás M, Fixa B, Kascák M et al (2004) Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut 53(11):1617–1623. https://doi.org/10.1136/gut.2003.037747
Kruis W, Kiudelis G, Rácz I, Gorelov IA, Pokrotnieks J, Horynski M et al (2009) Once daily versus three times daily mesalazine granules in active ulcerative colitis: a double-blind, double-dummy, randomised, non-inferiority trial. Gut 58(2):233–240. https://doi.org/10.1136/gut.2008.154302
Laharie D, Bourreille A, Branche J, Allez M, Bouhnik Y, FILIPPI J et al (2018) Long-term outcome of patients with steroid-refractory acute severe UC treated with ciclosporin or infliximab. Gut 67(2):237–243. https://doi.org/10.1136/gutjnl-2016-313060
Laharie D, Bourreille A, Branche J, Allez M, Bouhnik Y, Filippi J et al (2012) Ciclosporin versus infliximab in patients with severe ulcerative colitis refractory to intravenous steroids: a parallel, open-label randomised controlled trial. Lancet http://linkinghub.elsevier.com/retrieve/pii/S0140673612610848
Landy, J.; Walker, A. W.; Li, J. V.; Al-Hassi, H. O.; Ronde, E.; English, N. R. et al (2015): Variable alterations of the microbiota, without metabolic or immunological change, following faecal microbiota transplantation in patients with chronic pouchitis. In: Scientific reports 5, S. 12955. https://doi.org/10.1038/srep12955
Lang A, Salomon N, Wu JCY, Kopylov U, Lahat A, Har-Noy O et al (2015) Curcumin in combination with mesalamine induces remission in patients with mild-to-moderate ulcerative colitis in a randomized controlled trial. Clin Gastroenterol Hepatol 13(8):1444. https://doi.org/10.1016/j.cgh.2015.02.019
Langhorst J, Varnhagen I, Schneider SB, Albrecht U, Rueffer A, Stange R et al (2013) Randomised clinical trial: a herbal preparation of myrrh, chamomile and coffee charcoal compared with mesalazine in maintaining remission in ulcerative colitis–a double-blind, double-dummy study. Aliment Pharmacol Ther 38(5):490–500. https://doi.org/10.1111/apt.12397
Langhorst J, Anthonisen IB, Steder-Neukamm U, Lüdtke R, Spahn G, Michalsen A, Dobos GJ (2005) Amount of systemic steroid medication is a strong predictor for the use of complementary and alternative medicine in patients with inflammatory bowel disease: results from a German national survey. Inflamm Bowel Dis 11(3):287–295
Lawrance IC, Baird A, Lightower D, Radford-Smith G, Andrews JM, Connor S (2017) Efficacy of rectal tacrolimus for induction therapy in patients with resistant ulcerative proctitis. Clin Gastroenterol Hepatol 15(8):1248–1255. https://doi.org/10.1016/j.cgh.2017.02.027
Lees CW, Maan AK, Hansoti B, Satsangi J, Arnott IDR (2008) Tolerability and safety of mercaptopurine in azathioprine-intolerant patients with inflammatory bowel disease. Aliment Pharmacol Ther 27(3):220–227. https://doi.org/10.1111/j.1365-2036.2007.03570.x
Lemaitre M, Kirchgesner J, Rudnichi A, Carrat F, Zureik M, Carbonnel F, Dray-Spira R (2017) Association between use of thiopurines or tumor necrosis factor antagonists alone or in combination and risk of lymphoma in patients with inflammatory bowel disease. JAMA 318(17):1679–1686. https://doi.org/10.1001/jama.2017.16071
Lennard-Jones JE, Misiewicz JJ, Connell AM, Baron JH, Jones FA (1965) Prednisone as maintenance treatment for ulcerative colitis in remission. Lancet (London, England) 1(7378):188–189
Lichtiger S, Present DH, Kornbluth A, Gelernt I, Bauer J, Galler G et al (1994) Cyclosporine in severe ulcerative colitis refractory to steroid therapy. N Engl J Med 330(26):1841–1845. http://content.nejm.org/cgi/content/abstract/330/26/1841
Lopez A, Mounier M, Bouvier A-M, Carrat F, Maynadié M, Beaugerie L, Peyrin-Biroulet L (2014) Increased risk of acute myeloid leukemias and myelodysplastic syndromes in patients who received thiopurine treatment for inflammatory bowel disease. Clin Gastroenterol Hepatol 12(8):1324–1329. https://doi.org/10.1016/j.cgh.2014.02.026
Mantzaris GJ, Sfakianakis M, Archavlis E, Petraki K, Christidou A, Karagiannidis A, Triadaphyllou G (2004) A prospective randomized observer-blind 2-year trial of azathioprine monotherapy versus azathioprine and olsalazine for the maintenance of remission of steroid-dependent ulcerative colitis. Am J Gastroenterol 99(6):1122–1128. https://doi.org/10.1111/j.1572-0241.2004.11481.x
Marshall JK, Irvine EJ (1997) Rectal corticosteroids versus alternative treatments in ulcerative colitis: a meta-analysis. Gut 40(6):775–781
McLaughlin SD, Clark SK, Tekkis PP, Nicholls RJ, Ciclitira PJ (2010) The bacterial pathogenesis and treatment of pouchitis. Therap Adv Gastroenterol 3(6):335–348. https://doi.org/10.1177/1756283X10370611
Miglioli M, Barbara L, Di Febo G, Gozzetti G, Lauri A, Paganelli GM et al (1989) Topical administration of 5-aminosalicylic acid: a therapeutic proposal for the treatment of pouchitis. N Engl J Med 320(4):257. https://doi.org/10.1056/nejm198901263200423.
Mimura T, Rizzello F, Helwig U, Poggioli G, Schreiber S, Talbot IC et al (2004) Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis. Gut 53(1):108–114
Moayyedi P, Surette MG, Kim PT, Libertucci J, Wolfe M, Onischi C et al (2015) Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterology 149(1):102. https://doi.org/10.1053/j.gastro.2015.04.001
Naganuma M, Sugimoto S, Mitsuyama K, Kobayashi T, Yoshimura N, Ohi H et al (2018) Efficacy of indigo naturalis in a multicenter randomized controlled trial of patients with ulcerative colitis. Gastroenterology 154(4):935–947. https://doi.org/10.1053/j.gastro.2017.11.024
Ogata H, Matsui T, Nakamura M, Iida M, Takazoe M, Suzuki Y, Hibi T (2006) A randomised dose finding study of oral tacrolimus (FK506) therapy in refractory ulcerative colitis. Gut 55(9):1255–1262. http://gut.bmj.com/content/55/9/1255.abstract
Ogata H, Kato J, Hirai F, Hida N, Matsui T, Matsumoto T et al (2011) Double-blind, placebo-controlled trial of oral tacrolimus (FK506) in the management of hospitalized patients with steroid-refractory ulcerative colitis. Inflamm Bowel Dis, S. n/a. https://doi.org/10.1002/ibd.21853
Osterman, Mark T, Aberra, Faten N, Cross R, Liakos S, McCabe R, Shafran I et al (2014a) Mesalamine dose escalation reduces fecal calprotectin in patients with quiescent ulcerative colitis. In: Clin Gastroenterol hepatol: the official clinical practice journal of the American Gastroenterological Association 12(11):1887. https://doi.org/10.1016/j.cgh.2014.03.035
Osterman MT, Sandborn WJ, Colombel J-F, Robinson AM, Lau W, Huang B et al (2014b) Increased risk of malignancy with adalimumab combination therapy, compared with monotherapy, for crohn’s disease. Gastroenterology 146(4):941. https://doi.org/10.1053/j.gastro.2013.12.025
Panaccione R, Ghosh S, Middleton S, Márquez JR, Scott BB, Flint L et al (2014) Combination therapy with infliximab and azathioprine is superior to monotherapy with either agent in ulcerative colitis. Gastroenterology 146(2):392–400.e3. https://doi.org/10.1053/j.gastro.2013.10.052
Paramsothy S, Kamm MA, Kaakoush NO, Walsh AJ, van den Bogaerde J, Samuel D et al (2017) Multidonor intensive faecal microbiota transplantation for active ulcerative colitis. A randomised placebo-controlled trial. The Lancet. https://doi.org/10.1016/s0140-6736(17)30182-4
Peyrin-Biroulet L, Khosrotehrani K, Carrat F, Bouvier A-M, Chevaux J-B, Simon T et al (2011) Increased risk for nonmelanoma skin cancers in patients who receive thiopurines for inflammatory bowel disease. Gastroenterology 141(5):1621. https://doi.org/10.1053/j.gastro.2011.06.050
Reddy S, Friedman S, Telford JJ, Strate L, Ookubo R, Banks PA (2005) Are patients with inflammatory bowel disease receiving optimal care? Am J Gastroenterol 100(6):1357–1361. https://doi.org/10.1111/j.1572-0241.2005.40849.x
Regueiro M, Curtis J, Plevy S (2006) Infliximab for hospitalized patients with severe ulcerative colitis. J Clin Gastroenterol 40(6):476–481
Reinisch W, Sandborn WJ, Hommes DW, D’Haens G, Hanauer S, Schreiber S et al (2011a) Adalimumab for induction of clinical remission in moderately to severely active ulcerative colitis: results of a randomised controlled trial. Gut 60(6):780–787. https://doi.org/10.1136/gut.2010.221127
Reinisch W, Sandborn WJ, Rutgeerts P, Feagan BG, Rachmilewitz D, Hanauer SB et al (2011b) Long-term infliximab maintenance therapy for ulcerative colitis: The ACT-1 and -2 extension studies. Inflamm Bowel Dis. https://doi.org/10.1002/ibd.21697
Roblin X, Rinaudo M, Del Tedesco E, Phelip JM, Genin C, Peyrin-Biroulet L, Paul S (2014) Development of an algorithm incorporating pharmacokinetics of adalimumab in inflammatory bowel diseases. Am J Gastroenterol. https://doi.org/10.1038/ajg.2014.146
Rossen NG, Fuentes S, van der Spek MJ, Tijssen J, Hartman JHA, Duflou A et al (2015) Findings from a randomized controlled trial of fecal transplantation for patients with ulcerative colitis. Gastroenterology 149(1):110. https://doi.org/10.1053/j.gastro.2015.03.045
Rutgeerts P, Sandborn WJ, Feagan BG, Reinisch W, Olson A, Johanns J et al (2005) Infliximab for Induction and Maintenance Therapy for Ulcerative Colitis. N Engl J Med 353(23):2462–2476. https://doi.org/10.1056/NEJMoa050516
Safdi M, DeMicco M, Sninsky C, Banks P, Wruble L, Deren J et al (1997) A double-blind comparison of oral versus rectal mesalamine versus combination therapy in the treatment of distal ulcerative colitis. Am J Gastroenterol 92(10):1867–1871
Sandborn WJ, Bosworth B, Zakko S, Gordon GL.; Clemmons DR, Golden PL et al (2015) Budesonide foam induces remission in patients with mild to moderate ulcerative proctitis and ulcerative proctosigmoiditis. Gastroenterology. https://doi.org/10.1053/j.gastro.2015.01.037
Sandborn WJ, Feagan BG, Marano C, Zhang H, Strauss R, Johanns J et al (2014) Subcutaneous golimumab induces clinical response and remission in patients with moderate-to-severe ulcerative colitis. Gastroenterology 146(1):85–95, quiz e14-5. https://doi.org/10.1053/j.gastro.2013.05.048
Sandborn WJ, Feagan BG, Wolf DC, D’Haens G, Vermeire S, Hanauer SB et al (2016) Ozanimod induction and maintenance treatment for ulcerative colitis. N Engl J Med 374(18):1754–1762. https://doi.org/10.1056/NEJMoa1513248
Sandborn WJ, Korzenik J, Lashner B, Leighton JA, Mahadevan U, Marion JF et al (2010) Once-daily dosing of delayed-release oral mesalamine (400-mg tablet) is as effective as twice-daily dosing for maintenance of remission of ulcerative colitis. Gastroenterology 138(4):1286. https://doi.org/10.1053/j.gastro.2009.12.054
Sandborn WJ, Su C, Sands BE, D’Haens GR, Vermeire S, Schreiber S et al (2017) Tofacitinib as induction and maintenance therapy for ulcerative colitis. N Engl J Med 376(18):1723–1736. https://doi.org/10.1056/NEJMoa1606910
Sandborn WJ, Travis S, Moro L, Jones R, Gautille T, Bagin R et al (2012) Once-daily budesonide MMX® extended-release tablets induce remission in patients with mild to moderate ulcerative colitis: results from the CORE I study. Gastroenterology 143(5):1218. https://doi.org/10.1053/j.gastro.2012.08.003
Sandborn WJ, van Assche G, Reinisch W, Colombel J–F, D’Haens G, Wolf DC et al (2012) Adalimumab induces and maintains clinical remission in patients with moderate-to-severe ulcerative colitis. Gastroenterology 42(2):257–265.e3. https://doi.org/10.1053/j.gastro.2011.10.032
Segal JP, Ding NS, Worley G, Mclaughlin S, Preston S, Faiz OD et al (2017) Systematic review with meta-analysis: the management of chronic refractory pouchitis with an evidence-based treatment algorithm. Aliment Pharmacol Ther 45(5):581–592. https://doi.org/10.1111/apt.13905
Seibold F, Fournier N, Beglinger C, Mottet C, Pittet V, Rogler G (2014) Topical therapy is underused in patients with ulcerative colitis. J Crohns Colitis 8(1):56–63. https://doi.org/10.1016/j.crohns.2013.03.005
Shelton E, Allegretti JR, Stevens B, Lucci M, Khalili H, Nguyen DD et al (2015) Efficacy of vedolizumab as induction therapy in refractory IBD patients: a multicenter cohort. Inflamm bowel Dis 21(12):2879–2885. https://doi.org/10.1097/MIB.0000000000000561
Shen B, Achkar JP, Lashner BA, Ormsby AH, Remzi FH, Brzezinski A et al (2001) A randomized clinical trial of ciprofloxacin and metronidazole to treat acute pouchitis. Inflamm Bowel Dis 7(4):301–305
Shen B, Brzezinski A, Fazio VW, Remzi FH, Achkar J-P, Bennett AE et al (2005) Maintenance therapy with a probiotic in antibiotic-dependent pouchitis: experience in clinical practice. Aliment Pharmacol Ther 22(8):721–728. https://doi.org/10.1111/j.1365-2036.2005.02642.x
Shen B, Fazio VW, Remzi FH, Bennett AE, Lopez R, Brzezinski A et al (2007) Combined ciprofloxacin and tinidazole therapy in the treatment of chronic refractory pouchitis. Dis Colon Rectum 50(4):498–508. https://doi.org/10.1007/s10350-006-0828-3
Shen B, Lashner BA, Bennett AE, Remzi FH, Brzezinski A, Achkar J-P et al (2004) Treatment of rectal cuff inflammation (cuffitis) in patients with ulcerative colitis following restorative proctocolectomy and ileal pouch-anal anastomosis. Am J Gastroenterol 99(8):1527–1531. https://doi.org/10.1111/j.1572-0241.2004.30518.x
Shen B, Remzi FH, Lopez AR; Queener E (2008) Rifaximin for maintenance therapy in antibiotic-dependent pouchitis. BMC Gastroenterol 8:26. https://doi.org/10.1186/1471-230x-8-26
Singh S, Stroud AM, Holubar SD, Sandborn WJ, Pardi DS (2015) Treatment and prevention of pouchitis after ileal pouch-anal anastomosis for chronic ulcerative colitis. Cochrane Database Syst Rev (11):CD001176. https://doi.org/10.1002/14651858.cd001176.pub3
Stallmach A, Langbein C, Atreya R, Bruns T, Dignass A, Ende K et al (2016a) Vedolizumab provides clinical benefit over 1 year in patients with active inflammatory bowel disease – a prospective multicenter observational study. Alimentary Pharmacology & Therapeutics 44(11–12):1199–1212. https://doi.org/10.1111/apt.13813
Stallmach A, Lange K, B J, Sina C, Vital M, Pieper DH (2016b) Fecal microbiota transfer in patients with chronic antibiotic-refractory pouchitis. Am J Gastroenterol 111(3):441–443. https://doi.org/10.1038/ajg.2015.436
Svartz M (1948) The treatment of 124 cases of ulcerative colitis with salazopyrine and attempts of desensibilization in cases of hypersensitiveness to sulfa. Acta medica Scandinavica 131(Suppl 206):465–472
Terdiman JP (2011) The prevention of colitis-related cancer by 5-aminosalicylates: an appealing hypothesis that remains unproven. Am J Gastroenterol 106(4):737–740. http://dx.doi.org/10.1038/ajg.2011.56.
Timmer A, McDonald JWD, Macdonald JK (2007) Azathioprine and 6-mercaptopurine for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev (1):CD000478. https://doi.org/10.1002/14651858.cd000478.pub2
Travis SPL, Danese S, Kupcinskas L, Alexeeva O, D’Haens G, Gibson PR et al (2014) Once-daily budesonide MMX in active, mild-to-moderate ulcerative colitis: results from the randomised CORE II study. Gut 63(3):433–441. https://doi.org/10.1136/gutjnl-2012-304258
Truelove SC, Witts LJ (1955) Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J 2(4947):1041–1048
Truelove SC, Witts LJ (1959) Cortisone and corticotrophin in ulcerative colitis. Br Med J 1(5119):387–394
Ungar B, Mazor Y, Weisshof R, Yanai H, Ron Y, Goren I et al (2016) Induction infliximab levels among patients with acute severe ulcerative colitis compared with patients with moderately severe ulcerative colitis. Aliment Pharmacol Ther 43(12):1293–1299. https://doi.org/10.1111/apt.13631
Ungar B, Kopylov Uri, Yavzori Miri, Fudim E, Picard O, Lahat A et al (2017) Association of vedolizumab level, anti-drug antibodies, and α4β7 occupancy with response in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol: the official clinical practice journal of the American Gastroenterological Association. https://doi.org/10.1016/j.cgh.2017.11.050
Ungar B, Kopylov U, Yavzori M, Fudim E, Picard O, Lahat A et al (2018) Association of vedolizumab level, anti-drug antibodies, and α4β7 occupancy with response in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol 16(5):697–705.e7. https://doi.org/10.1016/j.cgh.2017.11.050
van Assche G, D’Haens G, Noman M, Vermeire S, Hiele M, Asnong K et al (2003) Randomized, double-blind comparison of 4 mg/kg versus 2 mg/kg intravenous cyclosporine in severe ulcerative colitis. Gastroenterology 125(4):1025–1031
van Bodegraven AA, Boer RO, Lourens J, Tuynman HA, Sindram JW (1996) Distribution of mesalazine enemas in active and quiescent ulcerative colitis. Aliment Pharmacol Ther 10(3):327–332
van Deventer SJH, Wedel MK, Baker BF, Xia S, Chuang E, Miner PB (2006) A phase II dose ranging, double-blind, placebo-controlled study of alicaforsen enema in subjects with acute exacerbation of mild to moderate left-sided ulcerative colitis. Aliment Pharmacol Ther 23(10):1415–1425. https://doi.org/10.1111/j.1365-2036.2006.02910.x
van Schaik FDM, van Oijen MGH, Smeets HM, van der Heijden GJMG, Siersema PD, Oldenburg B (2011) Thiopurines prevent advanced colorectal neoplasia in patients with inflammatory bowel disease. Gut. https://doi.org/10.1136/gut.2011.237412
Vande Casteele N, Ferrante M, van Assche G, Ballet V, Compernolle G, van Steen K et al (2015) Trough concentrations of infliximab guide dosing for patients with inflammatory bowel disease. Gastroenterology 148(7):1320. https://doi.org/10.1053/j.gastro.2015.02.031
Vermeire S, Sandborn WJ, Danese S, Hébuterne X, Salzberg BA, Klopocka M et al (2017) Anti-MAdCAM antibody (PF-00547659) for ulcerative colitis (TURANDOT). A phase 2, randomised, double-blind, placebo-controlled trial. Lancet (London, England) 390(10090):135–144. https://doi.org/10.1016/s0140-6736(17)30930-3
Viazis N, Giakoumis M, Koukouratos T, Anastasiou J, Katopodi K, Kechagias G et al (2013) Long term benefit of one year infliximab administration for the treatment of chronic refractory pouchitis. J Crohns Colitis 7(10):60. https://doi.org/10.1016/j.crohns.2013.02.018
Williet N, Boschetti G, Fovet M, Di Bernado T, Claudez P, Tedesco E Del et al (2017) Association between low trough levels of vedolizumab during induction therapy for inflammatory bowel diseases and need for additional doses within 6 months. Clin Gastroenterol Hepatol 15(11):1750–1757.e3. https://doi.org/10.1016/j.cgh.2016.11.023
Yamamoto S, Nakase H, Mikami S, Inoue S, Yoshino T, Takeda Y et al (2008) Long-term effect of tacrolimus therapy in patients with refractory ulcerative colitis. Aliment Pharmacol Ther 28(5):589–597. https://doi.org/10.1111/j.1365-2036.2008.03764.x
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Biedermann, L., Rogler, G. (2020). Medikamentöse Therapie der Colitis ulcerosa und Pouchitis. In: Hoffmann, J.C., Klump, B., Kroesen, A., Siegmund, B. (eds) Chronisch-entzündliche Darmerkrankungen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59104-8_20
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