nach oben

Tipp

Morbus Crohn Update

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

Erschienen in: Schweizer Gastroenterologie | Ausgabe 2/2023

Einloggen, um Zugang zu erhalten

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.

Vorheriger Artikel Editoriale

Nächster Artikel Wenn der Magen „nicht mehr richtig schafft“

Molodecky NA, Soon IS, Rabi DM, Ghali WA, Ferris M, Chernoff G et al (2012) Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 142(1):46–54 e42 (quiz e30) PubMedCrossRef

Ng SC, Kaplan GG, Tang W, Banerjee R, Adigopula B, Underwood FE et al (2019) Population density and risk of inflammatory bowel disease: a prospective population-based study in 13 countries or regions in asia-pacific. Am J Gastroenterol 114(1):107–115 PubMedCrossRef

Crohn BB, Ginzburg L, Oppenheimer GD (2000) Regional ileitis: a pathologic and clinical entity. 1932. Mt Sinai J Med 67(3):263–268 PubMed

Zhou M, He J, Shen Y, Zhang C, Wang J, Chen Y (2017) New frontiers in genetics, gut microbiota, and immunity: a Rosetta stone for the pathogenesis of inflammatory bowel disease. Biomed Res Int 2017:8201672 PubMedPubMedCentralCrossRef

Liu TC, Stappenbeck TS (2016) Genetics and pathogenesis of inflammatory bowel disease. Annu Rev Pathol 11:127–148 PubMedPubMedCentralCrossRef

Schnorbach MT, Kruis W (2021) Cost of illness of inflammatory bowel disease in Germany. Z Gastroenterol 59(11):1173–1188 PubMed

Stark R, Konig HH, Leidl R (2006) Costs of inflammatory bowel disease in Germany. PharmacoEconomics 24(8):797–814 PubMedCrossRef

Torres J, Mehandru S, Colombel JF, Peyrin-Biroulet L (2017) Crohn’s disease. Lancet 389(10080):1741–1755 PubMedCrossRef

Satsangi J, Silverberg MS, Vermeire S, Colombel JF (2006) The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 55(6):749–753 PubMedPubMedCentralCrossRef

10.

Maaser C, Sturm A, Vavricka SR, Kucharzik T, Fiorino G, Annese V et al (2019) ECCO-ESGAR guideline for diagnostic assessment in IBD part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis 13(2):144–164 PubMedCrossRef

11.

Authors C (2019) Updated S3-guideline ulcerative colitis. German society for digestive and metabolic diseases (DGVS). Z Gastroenterol 57(2):162–241 CrossRef

12.

Sulz M, Duetschler J, Seibold F (2020) Therapiealgorithmen für die Behandlung des Morbus Crohn im klinischen Alltag. Schweizer. Gastroenterol 2020(1):51–64. https://doi.org/10.1007/s43472-020-00009-9 CrossRef

13.

Mary JY, Modigliani R (1989) Development and validation of an endoscopic index of the severity for Crohns-Disease—a prospective multicenter study. Gut 30(7):983–989 PubMedPubMedCentralCrossRef

14.

Daperno M, D’Haens G, Van Assche G, Baert F, Bulois P, Maunoury V et al (2004) Development and validation of a new, simplified endoscopic activity score for Crohn’s disease: the SES-CD. Gastrointest Endosc 60(4):505–512 PubMedCrossRef

15.

Rutgeerts P, Geboes K, Vantrappen G, Beyls J, Kerremans R, Hiele M (1990) Predictability of the postoperative course of Crohns-Disease. Gastroenterol 99(4):956–963 CrossRef

16.

Gomollon F, Dignass A, Annese V, Tilg H, Van Assche G, Lindsay JO et al (2017) 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: part 1: diagnosis and medical management. J Crohns Colitis 11(1):3–25 PubMedCrossRef

17.

Shi JT, Chen N, Xu J, Goyal H, Wu ZQ, Zhang JX et al (2023) Diagnostic accuracy of fecal calprotectin for predicting relapse in inflammatory bowel disease: a meta-analysis. J Clin Med 12(3):1206. https://doi.org/10.3390/jcm12031206 CrossRefPubMedPubMedCentral

18.

Burri E, Beglinger C (2014) The use of fecal calprotectin as a biomarker in gastrointestinal disease. Expert Rev Gastroent 8(2):197–210 CrossRef

19.

Hong SW, Yoon H, Shin CM, Park YS, Kim N, Lee DH et al (2020) Clinical significance of granulomas in Crohn’s disease: A systematic review and meta-analysis. J Gastroenterol Hepatol 35(3):364–373 PubMedCrossRef

20.

Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK et al (2019) British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut 68(Suppl 3):s1–s106 PubMedCrossRef

21.

Sorensen LT, Malaki A, Wille-Jorgensen P, Kallehave F, Kjaergaard J, Hemmingsen U et al (2007) Risk factors for mortality and postoperative complications after gastrointestinal surgery. J Gastrointest Surg 11(7):903–910 PubMedCrossRef

22.

Rogler G, Singh A, Kavanaugh A, Rubin DT (2021) Extraintestinal manifestations of inflammatory bowel disease: current concepts, treatment, and implications for disease management. Gastroenterology 161(4):1118–1132 PubMedCrossRef

23.

Peyrin-Biroulet L, Sandborn W, Sands BE, Reinisch W, Bemelman W, Bryant RV et al (2015) Selecting therapeutic targets in inflammatory bowel disease (STRIDE): determining therapeutic goals for treat-to-target. Am J Gastroenterol 110(9):1324–1338 PubMedCrossRef

24.

Turner D, Ricciuto A, Lewis A, D’Amico F, Dhaliwal J, Griffiths AM et al (2021) STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology 160(5):1570–1583 PubMedCrossRef

25.

Torres J, Bonovas S, Doherty G, Kucharzik T, Gisbert JP, Raine T et al (2020) ECCO guidelines on therapeutics in Crohn’s disease: medical treatment. J Crohns Colitis 14(1):4–22 PubMedCrossRef

26.

Coward S, Kuenzig ME, Hazlewood G, Clement F, McBrien K, Holmes R et al (2017) Comparative effectiveness of mesalamine, sulfasalazine, corticosteroids, and budesonide for the induction of remission in Crohn’s disease: a Bayesian network meta-analysis: republished. Inflamm Bowel Dis 23(5):E26–E37 PubMedCrossRef

27.

Burisch J, Kiudelis G, Kupcinskas L, Kievit HAL, Andersen KW, Andersen V et al (2019) Natural disease course of Crohn’s disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study. Gut 68(3):423–433 PubMedCrossRef

28.

Rutgeerts PJ (2001) Review article: the limitations of corticosteroid therapy in Crohn’s disease. Aliment Pharm Ther 15(10):1515–1525 CrossRef

29.

Gionchetti P, Dignass A, Danese S, Dias FJM, Rogler G, Lakatos PL et al (2017) 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: part 2: surgical management and special situations. J Crohns Colitis 11(2):135–149 PubMedCrossRef

30.

Freeman K, Willis BH, Fraser H, Taylor-Phillips S, Clarke A (2019) Faecal calprotectin to detect inflammatory bowel disease: a systematic review and exploratory meta-analysis of test accuracy. Bmj Open 9(3):e27428 PubMedPubMedCentralCrossRef

31.

Swaminath A, Lebwohl B, Capiak KM, Present DH (2011) Practice patterns in the use of anti-tumor necrosis factor alpha agents in the management of Crohn’s disease: a US national practice survey comparing experts and non-experts. Digest Dis Sci 56(4):1160–1164 PubMedCrossRef

32.

Nielsen OH, Ainsworth MA (2013) Tumor necrosis factor inhibitors for inflammatory bowel disease. N Engl J Med 369(8):754–762 PubMedCrossRef

33.

Fine S, Papamichael K, Cheifetz AS (2019) Etiology and management of lack or loss of response to anti-tumor necrosis factor therapy in patients with inflammatory bowel disease. Gastroenterol Hepatol (n Y) 15(12):656–665 PubMed

34.

Ben-Horin S, Kopylov U, Chowers Y (2014) Optimizing anti-TNF treatments in inflammatory bowel disease. Autoimmun Rev 13(1):24–30 PubMedCrossRef

35.

Gisbert JP, Panes J (2009) Loss of response and requirement of Infliximab dose intensification in Crohn’s disease: a review. Am J Gastroenterol 104(3):760–767 PubMed

36.

Gisbert JP, Chaparro M (2020) Predictors of primary response to biologic treatment [anti-TNF, Vedolizumab, and Ustekinumab] in patients with inflammatory bowel disease: from basic science to clinical practice. J Crohns Colitis 14(5):694–709 PubMedCrossRef

37.

Apostolaki M, Armaka M, Victoratos P, Kollias G (2010) Cellular mechanisms of TNF function in models of inflammation and autoimmunity. Curr Dir Autoimmun 11:1–26 PubMedCrossRef

38.

D’Haens GR, Sandborn WJ, Loftus EV, Hanauer SB, Schreiber S, Peyrin-Biroulet L et al (2022) Higher vs standard adalimumab induction dosing regimens and two maintenance strategies: randomized SERENE CD trial results. Gastroenterology 162(7):1876–1890 PubMedCrossRef

39.

Sandborn WJ, Feagan BG, Stoinov S, Honiball PJ, Rutgeerts P, Mason D et al (2007) Certolizumab pegol for the treatment of Crohn’s disease. New Engl J Med 357(3):228–238 PubMedCrossRef

40.

Sands BE, Feagan BG, Rutgeerts P, Colombel JF, Sandborn WJ, Sy R et al (2014) Effects of vedolizumab induction therapy for patients with Crohn’s disease in whom tumor necrosis factor antagonist treatment failed. Gastroenterology 147(3):618 PubMedCrossRef

41.

Sandborn WJ, Feagan BG, Rutgeerts P, Hanauer S, Colombel JF, Sands BE et al (2013) Vedolizumab as induction and maintenance therapy for Crohn’s disease. New Engl J Med 369(8):711–721 PubMedCrossRef

42.

Loftus EV, Feagan BG, Panaccione R, Colombel JF, Sandborn WJ, Sands BE et al (2020) Long-term safety of vedolizumab for inflammatory bowel disease. Aliment Pharm Ther 52(8):1353–1365 CrossRef

43.

European Medicine Agency. Entyvio Summary of Product Characteristics.2014.

44.

Ryan C, Thrash B, Warren RB, Menter A (2010) The use of ustekinumab in autoimmune disease. Expert Opin Biol Th 10(4):587–604 CrossRef

45.

Agency EM. Stelara®2014.

46.

Feagan BG, Sandborn WJ, Gasink C, Jacobstein D, Lang Y, Friedman JR et al (2016) Ustekinumab as induction and maintenance therapy for Crohn’s disease. New Engl J Med 375(20):1946–1960 PubMedCrossRef

47.

Sandborn WJ, Gasink C, Gao LL, Blank MA, Johanns J, Guzzo C et al (2012) Ustekinumab induction and maintenance therapy in refractory Crohn’s disease. New Engl J Med 367(16):1519–1528 PubMedCrossRef

48.

D’Amico F, Peyrin-Biroulet L, Danese S (2022) J Crohns Colitis 16(Suppl 2):ii30–ii41 PubMedPubMedCentralCrossRef

49.

Guillo L, D’Amico F, Danese S, Peyrin-Biroulet L (2021) Ustekinumab for extra-intestinal manifestations of inflammatory bowel disease: a systematic literature review. J Crohns Colitis 15(7):1236–1243 PubMedCrossRef

50.

Sands BE, Irving PM, Hoops T, Izanec JL, Gao LL, Gasink C et al (2021) Ustekinumab versus adalimumab for induction and maintenance therapy in moderate-to-severe Crohn’s disease: the SEAVUE study. Gastroenterology 161(2):E30–E1 CrossRef

51.

Narula N, Wong ECL, Dulai PS, Sengupta NK, Marshall JK, Colombel JF et al (2022) Comparative efficacy and rapidity of action for Infliximab vs Ustekinumab in biologic naive Crohn’s disease. Clin Gastroenterol H 20(7):1579 CrossRef

52.

Hanauer SB, Sandborn WJ, Feagan BG, Gasink C, Jacobstein D, Zou B et al (2020) IM-UNITI: three-year efficacy, safety, and Immunogenicity of Ustekinumab treatment of Crohn’s disease. J Crohns Colitis 14(1):23–32 PubMedCrossRef

53.

Ma C, Jairath V, Khanna R, Feagan BG (2018) Investigational drugs in phase I and phase II clinical trials targeting interleukin 23 (IL23) for the treatment of Crohn’s disease. Expert Opin Inv Drug 27(8):649–660 CrossRef

54.

Ma C, Panaccione R, Khanna R, Feagan BG, Jairath V (2019) IL12/23 or selective IL23 inhibition for the management of moderate-to-severe Crohn’s disease? Best Pract Res Clin Gastroenterol. https://doi.org/10.1016/j.bpg.2019.02.006 CrossRefPubMed

55.

Schmitt H, Neurath MF, Atreya R (2021) Role of the IL23/IL17 pathway in Crohn’s disease. Front Immunol 12:622934 PubMedPubMedCentralCrossRef

56.

D’Haens GR, Colombel JF, Bossuyt P, Danese S, Lim A, Lindsay J et al (2021) Risankizumab induction therapy in patients with moderate-to-severe Crohn’s disease with intolerance or inadequate response to conventional and/or biologic therapy: results from the phase 3 ADVANCE study. Gastroenterology 161(2):E28 CrossRef

57.

Panaccione R, Schreiber S, Peyrin-Biroulet L, Loftus EV, Dubinsky M, Ferrante M et al (2021) Risankizumab as induction therapy in patients with moderately to severely active Crohn’s disease who failed 1 vs 〉 1 prior biologic treatment: results from the MOTIVATE study. Am J Gastroenterol 116:348 CrossRef

58.

Ferrante M, Panaccione R, Baert F, Bossuyt P, Colombel JF, Danese S et al (2022) Risankizumab as maintenance therapy for moderately to severely active Crohn’s disease: results from the multicentre, randomised, double-blind, placebo-controlled, withdrawal phase 3 FORTIFY maintenance trial. Lancet 399(10340):2031–2046 PubMedCrossRef

59.

Schmitt H, Billmeier U, Dieterich W, Rath T, Sonnewald S, Reid S et al (2019) Expansion of IL-23 receptor bearing TNFR2+T cells is associated with molecular resistance to anti-TNF therapy in Crohn’s disease. Gut 68(5):814–828 PubMedCrossRef

60.

Colombel JF, Sandborn WJ, Rutgeerts P (2010) Infliximab, Azathioprine, or Combination Therapy for Crohn’s Disease REPLY. New Engl J Med 363(11):1087–1088

61.

Ben-Horin S, Waterman M, Kopylov U, Yavzori M, Picard O, Fudim E et al (2013) Addition of an immunomodulator to Infliximab therapy eliminates antidrug antibodies in serum and restores clinical response of patients with inflammatory bowel disease. Clin Gastroenterol H 11(4):444–447 CrossRef

62.

Strik AS, van den Brink GR, Ponsioen C, Mathot R, Lowenberg M, D’Haens GR (2017) Suppression of anti-drug antibodies to infliximab or adalimumab with the addition of an immunomodulator in patients with inflammatory bowel disease. Aliment Pharm Ther 45(8):1128–1134 CrossRef

63.

Roblin X, Williet N, Boschetti G, Phelip JM, Del Tedesco E, Berger AE et al (2020) Addition of azathioprine to the switch of anti-TNF in patients with IBD in clinical relapse with undetectable anti-TNF trough levels and antidrug antibodies: a prospective randomised trial. Gut 69(7):1206–1212 PubMedCrossRef

64.

Yarur AJ, Kubiliun MJ, Czul F, Sussman DA, Quintero MA, Jain A et al (2015) Concentrations of 6‑Thioguanine nucleotide correlate with trough levels of Infliximab in patients with inflammatory bowel disease on combination therapy. Clin Gastroenterol H 13(6):1118 CrossRef

65.

Feagan BG, Sands BE, Sandborn WJ, Germinaro M, Vetter M, Shao J et al (2023) Guselkumab plus golimumab combination therapy versus guselkumab or golimumab monotherapy in patients with ulcerative colitis (VEGA): a randomised, double-blind, controlled, phase 2, proof-of-concept trial. Lancet Gastroenterol Hepatol 8(4):307–320 PubMedCrossRef

66.

Agency EM (2013) CHMP assessment report Remsima [EMA/CHMP/589317/2013]. EMA, London

67.

Danese S, Fiorino G, Raine T, Ferrante M, Kemp K, Kierkus J et al (2017) ECCO position statement on the use of biosimilars for inflammatory bowel disease—an update. J Crohns Colitis 11(1):26–34 PubMedCrossRef

68.

Ye BD, Pesegova M, Alexeeva O, Osipenko M, Lahat A, Dorofeyev A et al (2019) Efficacy and safety of biosimilar CT-P13 compared with originator infliximab in patients with active Crohn’s disease: an international, randomised, double-blind, phase 3 non-inferiority study. Lancet 393(10182):1699–1707 PubMedCrossRef

69.

Wasserbauer M, Hlava S, Drabek J, Stovicek J, Minarikova P, Nedbalova L et al (2022) Adalimumab biosimilars in the therapy of Crohn’s disease and ulcerative colitis: Prospective multicentric clinical monitoring. PLoS ONE 17(8):e271299 PubMedPubMedCentralCrossRef

70.

D’Amico F, Solitano V, Aletaha D, Hart A, Magro F, Selmi C et al (2021) Biobetters in patients with immune-mediated inflammatory disorders: An international Delphi consensus. Autoimmun Rev 20(7):102849 PubMedCrossRef

71.

Ma C (2022) To Stop or Not to Stop? Predicting Relapse After Anti-TNF Cessation in Patients With Crohn’s Disease. Clin Gastroenterol Hepatol 20(8):1668–1670 PubMedCrossRef

72.

Louis E, Mary JY, Vernier-Massouille G, Grimaud JC, Bouhnik Y, Laharie D et al (2012) Maintenance of remission among patients with Crohn’s disease on antimetabolite therapy after Infliximab therapy is stopped. Gastroenterology 142(1):63–U201 PubMedCrossRef

73.

Gisbert JP, Marin AC, Chaparro M (2016) The risk of relapse after anti-TNF discontinuation in inflammatory bowel disease: systematic review and meta-analysis. Am J Gastroenterol 111(5):632–647 PubMedCrossRef

74.

Reenaers C, Mary JY, Nachury M, Bouhnik Y, Laharie D, Allez M et al (2018) Outcomes 7 years after Infliximab withdrawal for patients with Crohn’s disease in sustained. Remission Clin Gastroenterol H 16(2):234 CrossRef

75.

Chaparro MMGD, Riestra S, Lucendo AJ et al (2023) Is the withdrawal of anti-tumour necrosis factor in inflammatory bowel disease patients in remission feasible without increasing the risk of relapse? Results from the randomised clinical trial of GETECCU (EXIT). J Crohn’s Colitis 17:i50–i4 CrossRef

76.

Doherty G, Katsanos KH, Burisch J, Allez M, Papamichael K, Stallmach A et al (2018) European Crohn’s and colitis organisation topical review on treatment withdrawal [‘exit strategies’] in inflammatory bowel disease. J Crohns Colitis 12(1):17–31 PubMedCrossRef

77.

Axelrad J, Bernheim O, Colombel JF, Malerba S, Ananthakrishnan A, Yajnik V et al (2016) Risk of new or recurrent cancer in patients with inflammatory bowel disease and previous cancer exposed to immunosuppressive and anti-tumor necrosis factor agents. Clin Gastroenterol H 14(1):58–64 CrossRef

78.

Lemaitre M, Kirchgesner J, Rudnichi A, Carrat F, Zureik M, Carbonnel F et al (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. J Am Med Assoc 318(17):1679–1686 CrossRef

79.

Dahmus J, Rosario M, Clarke K (2020) Risk of lymphoma associated with anti-TNF therapy in patients with inflammatory bowel disease: implications for therapy. Clin Exp Gastroenterol 13:339–350 PubMedCentralCrossRef

80.

Hedin CRH, Vavricka SR, Stagg AJ, Schoepfer A, Raine T, Puig L et al (2019) The pathogenesis of extraintestinal manifestations: implications for IBD research, diagnosis, and therapy. J Crohns Colitis 13(5):541–554 PubMedCrossRef

81.

Vermeire S, Schreiber S, Petryka R, Kuehbacher T, Hebuterne X, Roblin X et al (2017) Clinical remission in patients with moderate-to-severe Crohn’s disease treated with filgotinib (the FITZROY study): results from a phase 2, double-blind, randomised, placebo-controlled trial. Lancet 389(10066):266–275 PubMedCrossRef

82.

Sandborn WJ, Feagan BG, Loftus EV, Peyrin-Biroulet L, Van Assche G, D’Haens G et al (2020) Efficacy and safety of upadacitinib in a randomized trial of patients with Crohn’s disease. Gastroenterology 158(8):2123 PubMedCrossRef

83.

Hohenberger M, Cardwell LA, Oussedik E, Feldman SR (2018) Interleukin-17 inhibition: role in psoriasis and inflammatory bowel disease. J Dermatolog Treat 29(1):13–18 PubMedCrossRef

84.

Schwartz DA, Loftus EV, Tremaine WJ, Pannaccione R, Sandborn WJ (2000) The natural history of fistulizing Crohn’s disease: A population-based study. Gastroenterology 118(4):A337 CrossRef

85.

Bergstrand O, Ewerth S, Hellers G, Holmstrom B, Ullman J, Wallberg P (1980) Outcome following treatment of anal fistulae in Crohn’s disease. Acta Chir Scand Suppl 500:43–44 PubMed

86.

Hellers G, Bergstrand O, Ewerth S, Holmstrom B (1980) Occurrence and outcome after primary-treatment of anal fistulas in Crohns-disease. Gut 21(6):525–527 PubMedPubMedCentralCrossRef

87.

Bell SJ, Williams AB, Wiesel P, Wilkinson K, Cohen RC, Kamm MA (2003) The clinical course of fistulating Crohn’s disease. Aliment Pharmacol Ther 17(9):1145–1151 PubMedCrossRef

88.

Sandborn WJ, Fazio VW, Feagan BG, Hanauer SB, American Gastroenterological Association Clinical Practice C (2003) AGA technical review on perianal Crohn’s disease. Gastroenterology 125(5):1508–1530 PubMedCrossRef

89.

Parks AG, Gordon PH, Hardcastle JD (1976) A classification of fistula-in-ano. Br J Surg 63(1):1–12 PubMedCrossRef

90.

Molendijk I, Nuij VJ, van der Meulen-de Jong AE, van der Woude CJ (2014) Disappointing durable remission rates in complex Crohn’s disease fistula. Inflamm Bowel Dis 20(11):2022–2028 PubMedCrossRef

91.

Bouguen G, Siproudhis L, Gizard E, Wallenhorst T, Billioud V, Bretagne JF et al (2013) Long-term outcome of perianal fistulizing Crohn’s disease treated with infliximab. Clin Gastroenterol Hepatol 11(8):975–81 e1–4 PubMedCrossRef

92.

Adamina M, Bonovas S, Raine T, Spinelli A, Warusavitarne J, Armuzzi A et al (2020) ECCO guidelines on therapeutics in Crohn’s disease: surgical treatment. J Crohns Colitis 14(2):155–168 PubMedCrossRef

93.

Meima-van Praag EM, van Rijn KL, Wasmann K, Snijder HJ, Stoker J, D’Haens GR et al (2022) Short-term anti-TNF therapy with surgical closure versus anti-TNF therapy in the treatment of perianal fistulas in Crohn’s disease (PISA-II): a patient preference randomised trial. Lancet Gastroenterol Hepatol 7(7):617–626 PubMedCrossRef

94.

Singh S, Ding NS, Mathis KL, Dulai PS, Farrell AM, Pemberton JH et al (2015) Systematic review with meta-analysis: faecal diversion for management of perianal Crohn’s disease. Aliment Pharmacol Ther 42(7):783–792 PubMedPubMedCentralCrossRef

95.

Jones JL, Kaplan GG, Peyrin-Biroulet L, Baidoo L, Devlin S, Melmed GY et al (2015) Effects of concomitant Immunomodulator therapy on efficacy and safety of anti-tumor necrosis factor therapy for Crohn’s disease: a meta-analysis of placebo-controlled trials. Clin Gastroenterol H 13(13):2233 CrossRef

96.

Peyrin-Biroulet LRP, Gasink C, Hoops T et al (2022) Perianal fistula closure in patients receiving ustekinumab: Results from the SEAVUE and STARDUST trials. J Crohn’s Colitis 16:460 CrossRef

97.

Feagan BG, Schwartz D, Danese S, Rubin DT, Lissoos TW, Xu J et al (2018) Efficacy of vedolizumab in fistulising Crohn’s disease: exploratory analyses of data from GEMINI 2. J Crohns Colitis 12(5):621–626 PubMedPubMedCentralCrossRef

98.

Gingold DS, Murrell ZA, Fleshner PR (2014) A prospective evaluation of the ligation of the intersphincteric tract procedure for complex anal fistula in patients with Crohn’s disease. Ann Surg 260(6):1057–1061 PubMedCrossRef

99.

Soltani A, Kaiser AM (2010) Endorectal advancement flap for cryptoglandular or Crohn’s fistula-in-ano. Dis Colon Rectum 53(4):486–495 PubMedCrossRef

100.

Prosst RL, Herold A, Joos AK, Bussen D, Wehrmann M, Gottwald T et al (2012) The anal fistula claw: the OTSC clip for anal fistula closure. Colorectal Dis 14(9):1112–1117 PubMedCrossRef

101.

Senejoux A, Siproudhis L, Abramowitz L, Munoz-Bongrand N, Desseaux K, Bouguen G et al (2016) Fistula plug in fistulising ano-perineal Crohn’s disease: a randomised controlled trial. J Crohns Colitis 10(2):141–148 PubMedCrossRef

102.

Alam A, Lin F, Fathallah N, Pommaret E, Aubert M, Lemarchand N et al (2020) FiLaC((R)) and Crohn’s disease perianal fistulas: a pilot study of 20 consecutive patients. Tech Coloproctol 24(1):75–78 PubMedCrossRef

103.

Nauta AJ, Fibbe WE (2007) Immunomodulatory properties of mesenchymal stromal cells. Blood 110(10):3499–3506 PubMedCrossRef

104.

Cao Y, Su Q, Zhang B, Shen F, Li S (2021) Efficacy of stem cells therapy for Crohn’s fistula: a meta-analysis and systematic review. Stem Cell Res Ther 12(1):32 PubMedPubMedCentralCrossRef

105.

Cabalzar-Wondberg DMT (2020) Mesenchymale Stammzellen als neue Therapie bei Morbus-Crohn-Patienten mit Fisteln. Schweiz. Gastroenterol 1:130–137. https://doi.org/10.1007/s43472-020-00026-8 CrossRef

106.

Ponsioen CY, de Groof EJ, Eshuis EJ, Gardenbroek TJ, Bossuyt PMM, Hart A et al (2017) Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn’s disease: a randomised controlled, open-label, multicentre trial. Lancet Gastroenterol Hepatol 2(11):785–792 PubMedCrossRef

107.

Agrawal M, Ebert A, Poulsen G, Ungaro R (2023) OP11 Ileocecal resection for recently diagnosed ileocecal Crohn’s disease is associated with improved long-term outcomes compared to anti-tumor necrosis factor therapy: a population-based study

108.

Cohen BL, Fleshner P, Kane SV, Herfarth HH, Palekar N, Farraye FA et al (2022) Prospective cohort study to investigate the safety of preoperative tumor necrosis factor inhibitor exposure in patients with inflammatory bowel disease undergoing intra-abdominal surgery. Gastroenterology 163(1):204–221 PubMedCrossRef

109.

Manser C, Maillard MH, Rogler G, Schreiner P, Rieder F, Bühler S (2020) Vaccination in patients with inflammatory bowel diseases. Digestion 101:58–68 PubMedCrossRef

110.

Schreiner P, Mueller NJ, Fehr J, Maillard MH, Brand S, Michetti P et al (2021) Varicella zoster virus in inflammatory bowel disease patients: What every gastroenterologist should know. J Crohn’s Colitis. https://doi.org/10.1093/ecco-jcc/jjaa132 CrossRef

111.

Kucharzik T, Ellul P, Greuter T, Rahier JF, Verstockt B, Abreu C et al (2021) ECCO guidelines on the prevention, diagnosis, and management of infections in inflammatory bowel disease. J Crohn’s Colitis 15(6):879–913 CrossRef

112.

Caldera F, Hayney MS, Farraye FA (2020) Vaccination in patients with inflammatory bowel disease. Am J Gastroenterol 115:1356–1361 CrossRef

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

Springer Medizin Österreich

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Morbus Crohn Update

Zusammenfassung

Springer Medizin Österreich

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2023

Wenn der Magen „nicht mehr richtig schafft“

Editorial

Angriff aus dem Darm

Éditorial

Behandlungsstrategien und Operationsindikationen bei chronischer Divertikulitis

Editoriale