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Morbus Crohn Update

verfasst von: Dr. med. Andrea S. Kreienbuehl, PD Dr. med. Luc Biedermann

Erschienen in: Schweizer Gastroenterologie | Ausgabe 2/2023

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Zusammenfassung

Der chronische Krankheitsverlauf beim Morbus Crohn macht nicht selten eine lebenslange immunmodulatorische oder immunsuppressive Therapie nötig. Das therapeutische Spektrum wurde seit der Zulassung von Infliximab massgeblich erweitert. Nebst den TNF-Inhibitoren konnten sich Ustekinumab und Vedolizumab etablieren und stellen je nach Schwere respektive Ausdehnung der Erkrankung sowie unter Einbezug von extraintestinalen Manifestationen oder Komorbiditäten gleichwertige Erstlinientherapien dar. Als neuste Therapieoption stehen Risankizumab (Anti-IL-23) und voraussichtlich auch bald Upadacitinib kurz vor der Schweizer Marktzulassung. Kombinationstherapien – verschiedene Biologika oder Biologika + JAK-Inhibitoren – rücken weiter in den Fokus zukünftiger Therapiealgorithmen, und erste Resultate der Phase-3-Studie (Guselkumab/Golimumab) dürfen im nächsten Jahr erwartet werden. Weiterhin schwer therapierbar sind komplexe Verläufe bei Analfisteln, wobei sich in einer gut selektionierten Patientengruppe ein erfreuliches Ansprechen auf die mesenchymale Stammzelltherapie zeigt. Nebst den medikamentösen Therapieoptionen, sollte die Chirurgie (insbesondere Ileozökalresektion) in ihrem Stellenwert nicht vernachlässigt werden und kann je nach Ausgangslage – auch in einem frühen Erkrankungsstadium – ein valabler Therapieansatz sein.

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Titel: Morbus Crohn Update
verfasst von: Dr. med. Andrea S. Kreienbuehl
PD Dr. med. Luc Biedermann
Publikationsdatum: 07.06.2023
Verlag: Springer Vienna
Schlagwort: Morbus Crohn
Erschienen in: Schweizer Gastroenterologie / Ausgabe 2/2023
Print ISSN: 2662-7140
Elektronische ISSN: 2662-7159
DOI: https://doi.org/10.1007/s43472-023-00097-3

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Morbus Crohn Update

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