nach oben

Wiener klinisches Magazin

Erschienen in:

01.03.2023 | Gastroenterologie

Therapieupdate 2022: Colitis ulcerosa

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

Erschienen in: Wiener klinisches Magazin | Ausgabe 2/2023

Einloggen, um Zugang zu erhalten

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.

Vorheriger Artikel Arzneimittelwechselwirkungen – wie kann man sich vor der Informationsflut schützen?

Nächster Artikel Molekularpathologisch determinierte multimodale Therapie gastrointestinaler Stromatumoren

Hein R, Koster I, Bollschweiler E, Schubert I (2014) Prevalence of inflammatory bowel disease: estimates for 2010 and trends in Germany from a large insurance-based regional cohort. Scand J Gastroenterol 49(11):1325–1335. https://doi.org/10.3109/00365521.2014.962605CrossRefPubMed

Schnorbach MT, Kruis W (2021) Cost of illness of inflammatory bowel disease in Germany. Z Gastroenterol 59(11):1173–1188. https://doi.org/10.1055/a-1174-0670CrossRefPubMed

Kawalec P (2016) Indirect costs of inflammatory bowel diseases: Crohn’s disease and ulcerative colitis. A systematic review. Arch Med Sci 12(2):295–302. https://doi.org/10.5114/aoms.2016.59254CrossRefPubMedPubMedCentral

Stark R, Konig HH, Leidl R (2006) Costs of inflammatory bowel disease in Germany. PharmacoEconomics 24(8):797–814. https://doi.org/10.2165/00019053-200624080-00006CrossRefPubMed

Turner D, Ricciuto A, Lewis A, D’Amico F, Dhaliwal J, Griffiths AM, Bettenworth D, Sandborn WJ, Sands BE, Reinisch W, Scholmerich J, Bemelman W, Danese S, Mary JY, Rubin D, Colombel JF, Peyrin-Biroulet L, Dotan I, Abreu MT, Dignass A, International Organization for the Study of IBD (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. https://doi.org/10.1053/j.gastro.2020.12.031CrossRefPubMed

de Voogd F, van Wassenaer EA, Mookhoek A, Bots S, van Gennep S, Lowenberg M, D’Haens GR, Gecse KB (2022) Intestinal ultrasound is accurate to determine endoscopic response and remission in patients with moderate to severe ulcerative colitis: a longitudinal prospective cohort study. Gastroenterology. https://doi.org/10.1053/j.gastro.2022.08.038CrossRefPubMed

Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR, Caprilli R, Colombel JF, Gasche C, Geboes K, Jewell DP, Karban A, Loftus EV Jr., Pena AS, Riddell RH, Sachar DB, Schreiber S, Steinhart AH, Targan SR, Vermeire S, Warren BF (2005) Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a working party of the 2005 Montreal world congress of gastroenterology. Can J Gastroenterol 19(A):5A–36A. https://doi.org/10.1155/2005/269076CrossRefPubMed

Hoffmann JC (2020) Grundprinzipien der CED-Behandlung. In: Hoffmann JC, Klump B, Kroesen AJ, Siegmund B (Hrsg) Chronisch entzündliche Darmerkrankungen in Klinik und Praxis, 3. Aufl. Springer, Berlin, S 199–206CrossRef

Johnson AM, Harmsen WS, Aniwan S, Tremaine WJ, Abu Dayyeh BK, Loftus EV (2021) Prevalence and impact of obesity on disease-specific outcomes in a population-based cohort of patients with ulcerative colitis. J Crohns Colitis 15(11):1816–1823. https://doi.org/10.1093/ecco-jcc/jjab097CrossRefPubMedPubMedCentral

10.

Kurnool S, Nguyen NH, Proudfoot J, Dulai PS, Boland BS, Vande Casteele N, Evans E, Grunvald EL, Zarrinpar A, Sandborn WJ, Singh S (2018) High body mass index is associated with increased risk of treatment failure and surgery in biologic-treated patients with ulcerative colitis. Aliment Pharmacol Ther 47(11):1472–1479. https://doi.org/10.1111/apt.14665CrossRefPubMedPubMedCentral

11.

Biedermann L, Rogler G (2020) Medikamentöse Therapie der Colitis ulcerosa und Pouchitis. In: Hoffmann JC, Klump B, Kroesen AJ, Siegmund B (Hrsg) Chronisch entzündliche Darmerkrankungen in Klinik und Praxis. Springer, Berlin, S 285–304CrossRef

12.

El Hage Chehade N, Ghoneim S, Shah S, Chahine A, Mourad FH, Francis FF, Binion DG, Farraye FA, Hashash JG (2022) Efficacy of fecal microbiota transplantation in the treatment of active ulcerative colitis: a systematic review and meta-analysis of double-blind randomized controlled trials. Inflamm Bowel Dis. https://doi.org/10.1093/ibd/izac135CrossRefPubMed

13.

Kedia S, Virmani S, Vuyyuru SK, Kumar P, Kante B, Sahu P, Kaushal K, Farooqui M, Singh M, Verma M, Bajaj A, Markandey M, Sachdeva K, Das P, Makharia GK, Ahuja V (2022) Faecal microbiota transplantation with anti-inflammatory diet (FMT-AID) followed by anti-inflammatory diet alone is effective in inducing and maintaining remission over 1 year in mild to moderate ulcerative colitis: a randomised controlled trial. Gut. https://doi.org/10.1136/gutjnl-2022-327811CrossRefPubMed

14.

Siegmund B (2017) Cytomegalovirus infection associated with inflammatory bowel disease. Lancet Gastroenterol Hepatol 2(5):369–376. https://doi.org/10.1016/S2468-1253(16)30159-5CrossRefPubMed

15.

Kremer AE, Budenhofer U, Beuers U, Rust C (2008) A 47-year-old dog breeder with chronic polyarthritis, weight loss and high fever. Z Gastroenterol 46(5):431–434CrossRefPubMed

16.

Dulai PS, Rai V, Raffals LE, Lukin D, Hudesman D, Kochhar GS, Damas OM, Sauk JS, Levy AN, Sofia MA, Tuskey A, Deepak P, Yarur AJ, Afzali A, Ananthakrishnan AN, Cross RK, Hanauer SB, Siegel CA (2022) Recommendations on the appropriate management of steroids and discharge planning during and after hospital admission for moderate-severe ulcerative colitis: results of a RAND appropriateness panel. Am J Gastroenterol 117(8):1288–1295. https://doi.org/10.14309/ajg.0000000000001775CrossRefPubMed

17.

Kucharzik T, Dignass AU, Atreya R, Bokemeyer B, Esters P, Herrlinger K, Kannengiesser K, Kienle P, Langhorst J, Lugering A, Schreiber S, Stallmach A, Stein J, Sturm A, Teich N, Siegmund B (2020) Z Gastroenterol 58(12):e241–e326. https://doi.org/10.1055/a-1296-3444CrossRefPubMed

18.

Herfarth H, Vavricka SR (2022) 5‑Aminosalicylic acid chemoprevention in inflammatory bowel diseases: is it necessary in the age of biologics and small molecules? Inflamm Intest Dis 7(1):28–35. https://doi.org/10.1159/000518865CrossRefPubMed

19.

Kruis W, Fric P, Pokrotnieks J, Lukas M, Fixa B, Kascak M, Kamm MA, Weismueller J, Beglinger C, Stolte M, Wolff C, Schulze J (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.2003.037747CrossRefPubMedPubMedCentral

20.

Timmer A, Patton PH, Chande N, McDonald JW, MacDonald JK (2016) Azathioprine and 6‑mercaptopurine for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev 5:CD478. https://doi.org/10.1002/14651858.CD000478.pub4CrossRef

21.

Kiszka-Kanowitz M, Theede K, Thomsen SB, Bjerrum JT, Brynskov J, Gottschalck IB, Akimenko E, Hilsted KL, Neumann A, Wildt S, Larsen L, Munk JK, Ibsen PH, Janjua HGR, Gluud LL, Mertz-Nielsen A (2022) Low-dose azathioprine and allopurinol versus azathioprine monotherapy in patients with ulcerative colitis (AAUC): an investigator-initiated, open, multicenter, parallel-arm, randomised controlled trial. EClinicalMedicine 45:101332. https://doi.org/10.1016/j.eclinm.2022.101332CrossRefPubMedPubMedCentral

22.

Beaugerie L, Brousse N, Bouvier AM, Colombel JF, Lemann M, Cosnes J, Hebuterne X, Cortot A, Bouhnik Y, Gendre JP, Simon T, Maynadie M, Hermine O, Faivre J, Carrat F (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)61302-7CrossRefPubMed

23.

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.2017.16071CrossRefPubMedPubMedCentral

24.

Long MD, Martin CF, Pipkin CA, Herfarth HH, Sandler RS, Kappelman MD (2012) Risk of melanoma and nonmelanoma skin cancer among patients with inflammatory bowel disease. Gastroenterology 143(2):390–399. https://doi.org/10.1053/j.gastro.2012.05.004CrossRefPubMed

25.

Narous M, Nugent Z, Singh H, Bernstein CN (2022) Risks of melanoma and nonmelanoma skin cancers pre- and post-inflammatory bowel disease diagnosis. Inflamm Bowel Dis. https://doi.org/10.1093/ibd/izac171CrossRefPubMed

26.

Reinisch W, Sandborn WJ, Rutgeerts P, Feagan BG, Rachmilewitz D, Hanauer SB, Lichtenstein GR, de Villiers WJ, Blank M, Lang Y, Johanns J, Colombel JF, Present D, Sands BE (2012) Long-term infliximab maintenance therapy for ulcerative colitis: the ACT‑1 and -2 extension studies. Inflamm Bowel Dis 18(2):201–211. https://doi.org/10.1002/ibd.21697CrossRefPubMed

27.

Rutgeerts P, Sandborn WJ, Feagan BG, Reinisch W, Olson A, Johanns J, Travers S, Rachmilewitz D, Hanauer SB, Lichtenstein GR, de Villiers WJ, Present D, Sands BE, Colombel JF (2005) Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 353(23):2462–2476. https://doi.org/10.1056/NEJMoa050516CrossRefPubMed

28.

Schreiber S, Ben-Horin S, Leszczyszyn J, Dudkowiak R, Lahat A, Gawdis-Wojnarska B, Pukitis A, Horynski M, Farkas K, Kierkus J, Kowalski M, Lee SJ, Kim SH, Suh JH, Kim MR, Lee SG, Ye BD, Reinisch W (2021) Randomized controlled trial: subcutaneous vs intravenous Infliximab CT-P13 maintenance in inflammatory bowel disease. Gastroenterology 160(7):2340–2353. https://doi.org/10.1053/j.gastro.2021.02.068CrossRefPubMed

29.

Burr NE, Gracie DJ, Black CJ, Ford AC (2021) Efficacy of biological therapies and small molecules in moderate to severe ulcerative colitis: systematic review and network meta-analysis. Gut. https://doi.org/10.1136/gutjnl-2021-326390CrossRefPubMed

30.

Panes J, Colombel JF, D’Haens GR, Schreiber S, Panaccione R, Peyrin-Biroulet L, Loftus EV Jr., Danese S, Tanida S, Okuyama Y, Louis E, Armuzzi A, Ferrante M, Vogelsang H, Hibi T, Watanabe M, Lefebvre J, Finney-Hayward T, Sanchez Gonzalez Y, Doan TT, Mostafa NM, Ikeda K, Xie W, Huang B, Petersson J, Kalabic J, Robinson AM, Sandborn WJ (2022) Higher vs standard adalimumab induction and maintenance dosing regimens for treatment of ulcerative colitis: SERENE UC trial results. Gastroenterology 162(7):1891–1910. https://doi.org/10.1053/j.gastro.2022.02.033CrossRefPubMed

31.

Kirchgesner J, Lemaitre M, Carrat F, Zureik M, Carbonnel F, Dray-Spira R (2018) Risk of serious and opportunistic infections associated with treatment of inflammatory bowel diseases. Gastroenterology 155(2):337–346. https://doi.org/10.1053/j.gastro.2018.04.012CrossRefPubMed

32.

Sandborn WJ, Baert F, Danese S, Krznaric Z, Kobayashi T, Yao X, Chen J, Rosario M, Bhatia S, Kisfalvi K, D’Haens G, Vermeire S (2020) Efficacy and safety of vedolizumab subcutaneous formulation in a randomized trial of patients with ulcerative colitis. Gastroenterology 158(3):562–572.e12. https://doi.org/10.1053/j.gastro.2019.08.027CrossRefPubMed

33.

Christensen B, Gibson PR, Micic D, Colman RJ, Goeppinger SR, Kassim O, Yarur A, Weber CR, Cohen RD, Rubin DT (2019) Safety and efficacy of combination treatment with calcineurin inhibitors and vedolizumab in patients with refractory inflammatory bowel disease. Clin Gastroenterol Hepatol 17(3):486–493. https://doi.org/10.1016/j.cgh.2018.04.060CrossRefPubMed

34.

Pellet G, Stefanescu C, Carbonnel F, Peyrin-Biroulet L, Roblin X, Allimant C, Nachury M, Nancey S, Filippi J, Altwegg R, Brixi H, Fotsing G, de Rosamel L, Shili S, Laharie D (2019) Efficacy and safety of induction therapy with calcineurin inhibitors in combination with vedolizumab in patients with refractory ulcerative colitis. Clin Gastroenterol Hepatol 17(3):494–501. https://doi.org/10.1016/j.cgh.2018.08.081CrossRefPubMed

35.

Sands BE, Peyrin-Biroulet L, Loftus EV Jr., Danese S, Colombel JF, Toruner M, Jonaitis L, Abhyankar B, Chen J, Rogers R, Lirio RA, Bornstein JD, Schreiber S, VARSITY Study Group (2019) Vedolizumab versus adalimumab for moderate-to-severe ulcerative colitis. N Engl J Med 381(13):1215–1226. https://doi.org/10.1056/NEJMoa1905725CrossRefPubMed

36.

Card T, Ungaro R, Bhayat F, Blake A, Hantsbarger G, Travis S (2020) Vedolizumab use is not associated with increased malignancy incidence: GEMINI LTS study results and post-marketing data. Aliment Pharmacol Ther 51(1):149–157. https://doi.org/10.1111/apt.15538CrossRefPubMed

37.

Fries W, Demarzo MG, Navarra G, Viola A (2022) Ulcerative colitis in adulthood and in older patients: same disease, same outcome, same risks? Drugs Aging 39(6):441–452. https://doi.org/10.1007/s40266-022-00943-0CrossRefPubMedPubMedCentral

38.

Hahn GD, Golovics PA, Wetwittayakhlang P, Santa Maria DM, Britto U, Wild GE, Afif W, Bitton A, Bessissow T, Lakatos PL (2022) Safety of biological therapies in elderly inflammatory bowel diseases: a systematic review and meta-analysis. J Clin Med. https://doi.org/10.3390/jcm11154422CrossRefPubMedPubMedCentral

39.

Pugliese D, Privitera G, Crispino F, Mezzina N, Castiglione F, Fiorino G, Laterza L, Viola A, Bertani L, Caprioli F, Cappello M, Barberio B, Ricci C, Balestrieri P, Daperno M, Pluchino D, Rizzello F, Scribano ML, Sablich R, Pastorelli L, Manguso F, Variola A, Di Sario A, Grossi L, Armuzzi A, IG‐IBD LIVE Study Group (2022) Effectiveness and safety of vedolizumab in a matched cohort of elderly and nonelderly patients with inflammatory bowel disease: the IG-IBD LIVE study. Aliment Pharmacol Ther 56(1):95–109. https://doi.org/10.1111/apt.16923CrossRefPubMedPubMedCentral

40.

Abreu MT, Rowbotham DS, Danese S, Sandborn WJ, Miao Y, Zhang H, Tikhonov I, Panaccione R, Hisamatsu T, Scherl EJ, Leong RW, Arasaradnam RP, Afif W, Peyrin-Biroulet L, Sands BE, Marano C (2022) Efficacy and safety of maintenance ustekinumab for ulcerative colitis through 3 years: UNIFI long-term extension. J Crohns Colitis 16(8):1222–1234. https://doi.org/10.1093/ecco-jcc/jjac030CrossRefPubMedPubMedCentral

41.

Danese S, Sands BE, Abreu MT, O’Brien CD, Bravata I, Nazar M, Miao Y, Wang Y, Rowbotham D, Leong RWL, Arasaradnam RP, Afif W, Marano C (2022) Early symptomatic improvement after ustekinumab therapy in patients with ulcerative colitis: 16-week data from the UNIFI trial. Clin Gastroenterol Hepatol. https://doi.org/10.1016/j.cgh.2022.02.050CrossRefPubMed

42.

Sands BE, Sandborn WJ, Panaccione R, O’Brien CD, Zhang H, Johanns J, Adedokun OJ, Li K, Peyrin-Biroulet L, Van Assche G, Danese S, Targan S, Abreu MT, Hisamatsu T, Szapary P, Marano C, UNIFI Study Group (2019) Ustekinumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 381(13):1201–1214. https://doi.org/10.1056/NEJMoa1900750CrossRefPubMed

43.

Sandborn WJ, Rebuck R, Wang Y, Zou B, Adedokun OJ, Gasink C, Sands BE, Hanauer SB, Targan S, Ghosh S, de Villiers WJS, Colombel JF, Feagan BG, Lynch JP (2022) Five-year efficacy and safety of ustekinumab treatment in Crohn’s disease: the IM-UNITI trial. Clin Gastroenterol Hepatol 20(3):578–590. https://doi.org/10.1016/j.cgh.2021.02.025CrossRefPubMed

44.

Sandborn WJ, Ferrante M, Bhandari BR, Berliba E, Feagan BG, Hibi T, Tuttle JL, Klekotka P, Friedrich S, Durante M, Morgan-Cox M, Laskowski J, Schmitz J, D’Haens GR (2020) Efficacy and safety of mirikizumab in a randomized phase 2 study of patients with ulcerative colitis. Gastroenterology 158(3):537–549. https://doi.org/10.1053/j.gastro.2019.08.043CrossRefPubMed

45.

Sandborn WJ, Ferrante M, Bhandari BR, Berliba E, Hibi T, D’Haens GR, Tuttle JL, Krueger K, Friedrich S, Durante M, Arora V, Naegeli AN, Schmitz J, Feagan BG (2022) Efficacy and safety of continued treatment with mirikizumab in a phase 2 trial of patients with ulcerative colitis. Clin Gastroenterol Hepatol 20(1):105–115.e14. https://doi.org/10.1016/j.cgh.2020.09.028CrossRefPubMed

46.

Feagan BG, Danese S, Loftus EV Jr., Vermeire S, Schreiber S, Ritter T, Fogel R, Mehta R, Nijhawan S, Kempinski R, Filip R, Hospodarskyy I, Seidler U, Seibold F, Beales ILP, Kim HJ, McNally J, Yun C, Zhao S, Liu X, Hsueh CH, Tasset C, Besuyen R, Watanabe M, Sandborn WJ, Rogler G, Hibi T, Peyrin-Biroulet L (2021) Filgotinib as induction and maintenance therapy for ulcerative colitis (SELECTION): a phase 2b/3 double-blind, randomised, placebo-controlled trial. Lancet 397(10292):2372–2384. https://doi.org/10.1016/S0140-6736(21)00666-8CrossRefPubMed

47.

Sandborn WJ, Feagan BG, D’Haens G, Wolf DC, Jovanovic I, Hanauer SB, Ghosh S, Petersen A, Hua SY, Lee JH, Charles L, Chitkara D, Usiskin K, Colombel JF, Laine L, Danese S, True North Study Group (2021) Ozanimod as induction and maintenance therapy for ulcerative colitis. N Engl J Med 385(14):1280–1291. https://doi.org/10.1056/NEJMoa2033617CrossRefPubMed

48.

Danese S, Vermeire S, Zhou W, Pangan AL, Siffledeen J, Greenbloom S, Hébuterne X, D’Haens G, Nakase H, Panés J, Higgins PDR, Juillerat P, Lindsay JO, Loftus EV Jr, Sandborn WJ, Reinisch W, Chen MH, Sanchez Gonzalez Y, Huang B, Xie W, Liu J, Weinreich MA, Panaccione R (2022) Upadacitinib as induction and maintenance therapy for moderately to severely active ulcerative colitis: results from three phase 3, multicentre, double-blind, randomised trials. Lancet 399(10341):2113–2128. https://doi.org/10.1016/S0140-6736(22)00581-5

49.

Sandborn WJ, Su C, Sands BE, D’Haens GR, Vermeire S, Schreiber S, Danese S, Feagan BG, Reinisch W, Niezychowski W, Friedman G, Lawendy N, Yu D, Woodworth D, Mukherjee A, Zhang H, Healey P, Panes J, OCTAVE Induction 1, OCTAVE Induction 2, and OCTAVE Sustain Investigators (2017) Tofacitinib as induction and maintenance therapy for ulcerative colitis. N Engl J Med 376(18):1723–1736. https://doi.org/10.1056/NEJMoa1606910CrossRefPubMed

50.

FDA (2021) Initial safety trial results find increased risk of serious heart-related problems and cancer with arthritis and ulcerative colitis medicine Xeljanz, Xeljanz XR (tofacitinib)

51.

EMA (2020) EMA confirms Xeljanz to be used with caution in patients at high risk of blood clots

52.

Meissner Y, Albrecht K, Kekow J, Zinke S, Tony HP, Schaefer M (2022) Risk of cardiovascular events under januse kinase inhibitors in patients with rheumatoid arthritis: observational data from the German RABBIT register. Ann Rheum Dis 81:86–87CrossRef

53.

Burmester GR, Nash P, Sands BE, Papp K, Stockert L, Jones TV, Tan H, Madsen A, Valdez H, Cohen SB (2021) Adverse events of special interest in clinical trials of rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and psoriasis with 37 066 patient-years of tofacitinib exposure. RMD Open. https://doi.org/10.1136/rmdopen-2021-001595CrossRefPubMedPubMedCentral

54.

Selmaj KW, Cohen JA, Comi G, Bar-Or A, Arnold DL, Steinman L, Hartung HP, Montalban X, Havrdova EK, Cree BAC, Minton N, Sheffield JK, Ding N, Kappos L (2021) Ozanimod in relapsing multiple sclerosis: pooled safety results from the clinical development program. Mult Scler Relat Disord 51:102844. https://doi.org/10.1016/j.msard.2021.102844CrossRefPubMed

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 / Ausgabe 2/2023
Print ISSN: 1869-1757
Elektronische ISSN: 1613-7817
DOI: https://doi.org/10.1007/s00740-023-00484-1

Springer Medizin Österreich

Zusammenfassung

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

Weitere Artikel der Ausgabe 2/2023

Reaktive Lymphadenopathien

Ein neuer Mitspieler in der Kommunikation

Arzneimittelwechselwirkungen – wie kann man sich vor der Informationsflut schützen?

Panorama

Molekularpathologisch determinierte multimodale Therapie gastrointestinaler Stromatumoren