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Erschienen in: rheuma plus 5/2020

07.08.2020 | Rheumatologie | Unerwünschte Wirkungen

Biosimilars und der Nocebo-Effekt

verfasst von: J. Braun, S. Tsiami, B. Buehring, D. Kiefer, I. Andreica, X. Baraliakos, PD Dr. med. U. Kiltz

Erschienen in: rheuma plus | Ausgabe 5/2020

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Zusammenfassung

In Deutschland sind seit vielen Jahren Biosimilars zugelassen, seit wenigen Jahren auch in der Rheumatologie. Zwar haben die Biosimilars, die wie die Referenzbiologika biotechnologisch hergestellten Produkte sind, inzwischen in einigen Regionen schon erheblich Marktanteile erreicht, es gibt aber bei Patienten und Ärzten immer noch viele Zweifler, die einen Qualitätsverlust befürchten – auch, wenn es dafür keinen Anhalt gibt. Ein Teil dieses Problems ist durch den Nocebo-Effekt zu erklären, der aber auch darüber hinaus eine erhebliche medizinische Bedeutung hat. Dieser Effekt wird in diesem Artikel beschrieben und erläutert. Psychosoziale und kontextbezogene Faktoren wie die Beziehung zwischen Patient und Arzt, frühere Behandlungserfahrungen und Behandlungserwartungen können die Wirksamkeit einer therapeutischen Intervention entweder verbessern oder beeinträchtigen. Diese Phänomene werden üblicherweise als Placebo- und Nocebo-Effekte bezeichnet. Da Placebo- und Nocebo-Effekte die Symptomentwicklung, die Häufigkeit unerwünschter Ereignisse und die Wirksamkeit der Behandlung beeinflussen können, ist es entscheidend, diese Effekte zu kennen und Strategien zur Prävention zu entwickeln, um die Behandlungsergebnisse zu optimieren. Während experimentelle Studien in den letzten Jahren wesentliche Fortschritte bei der Aufklärung der psychosozialen und neurobiologischen Mechanismen von Placebo-Effekten erzielt haben, sind die detaillierten Mechanismen von Nocebo-Effekten noch weitgehend unerforscht. Ein besseres Verständnis dieser Mechanismen verspricht die Entwicklung benutzerfreundlicher Strategien für die klinische Versorgung zur Verbesserung der Behandlungsergebnisse und der Patientenzufriedenheit.
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Metadaten
Titel
Biosimilars und der Nocebo-Effekt
verfasst von
J. Braun
S. Tsiami
B. Buehring
D. Kiefer
I. Andreica
X. Baraliakos
PD Dr. med. U. Kiltz
Publikationsdatum
07.08.2020
Verlag
Springer Vienna
Schlagwort
Rheumatologie
Erschienen in
rheuma plus / Ausgabe 5/2020
Print ISSN: 1868-260X
Elektronische ISSN: 2191-2610
DOI
https://doi.org/10.1007/s12688-020-00366-y

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