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Therapieupdate 2022: Colitis ulcerosa

verfasst von: Prof. Dr. Jörg C. Hoffmann, Dr. Jörg Edelmann

Erschienen in: Wiener klinisches Magazin

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Zusammenfassung

Mit über 300.000 Betroffenen in Deutschland und Kosten von über 10 Mrd. €/Jahr stellt die Colitis ulcerosa eine wichtige Erkrankung dar. Therapieziele sind klinische Remission, Verhinderung struktureller Schäden (mukosale und histologische Heilung) und gute Lebensqualität. Dazu ist eine Stratifizierung anhand von Risikofaktoren (junges Erkrankungsalter, tiefe Ulzera, Pankolitis, Mangelernährung und Therapierefraktärität) sinnvoll. Treten im Verlauf refraktäre Schübe auf, müssen Infektionen, besonders durch Zytomegalievirus (CMV) und Clostridien, ausgeschlossen werden. Neben Steroiden (nur im Schub) kommen Aminosalizylate zum Einsatz, Thiopurine in der Remissionserhaltung. Zusätzlich zu Antikörpern gegen Tumornekrosefaktor(TNF)-α (Infliximab) stehen Vedolizumab und Ustekinumab als Biologika zur Verfügung. Neue Alternativen sind Januskinaseinhibitoren (Tofacitinib, Filgotinib, Upadacitinib) sowie der Sphingosin-1-Phosphat-Modulator Ozanimod. Kontraindikationen und das jeweilige Nebenwirkungsprofile müssen beachtet werden.

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Titel: Therapieupdate 2022: Colitis ulcerosa
verfasst von: Prof. Dr. Jörg C. Hoffmann
Dr. Jörg Edelmann
Publikationsdatum: 01.03.2023
Verlag: Springer Vienna
Erschienen in: Wiener klinisches Magazin
Print ISSN: 1869-1757
Elektronische ISSN: 1613-7817
DOI: https://doi.org/10.1007/s00740-023-00484-1

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