Z Gastroenterol 2001; 39(1): 47-49
DOI: 10.1055/s-2001-10699
Leitlinien der DGVS
© Karl Demeter Verlag im Georg Thieme Verlag Stuttgart · New York

Remission

W. Kruis
  • Köln
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Definition

Konsens

Die Remission der CU wird klinisch definiert. Kriterien der Remission sind Abwesenheit von Diarrhö (nicht > 3 Stühle/d), kein sichtbares Blut im Stuhl, keine durch die CU bedingten intestinalen oder extraintestinalen Beschwerden (C).

Erläuterung

Von den verschiedenen Kriterien Klinik, Morphologie und Labor ist das klinische Kriterium als einziges in allen wissenschaftlichen Untersuchungen, die für die Therapieentscheidung herangezogen werden, enthalten. Es gibt Evidenz dafür, dass das zusätzliche Vorhandensein einer endoskopischen [1] oder histologischen [2] [3] Remission auch mit einer stabileren klinischen Remission einhergeht.

Literatur

  • 1 Courtney M G, Nunes D P, Bergin C F. et al . Colonoscopic but not histological appearances determine liklyhood of relapse of ulcerative colitis.  Am J Gastroenterol. 1991;  86 243 (III)
  • 2 Goodman M W, Eberle D E, Kuchler L A, Fossum E A. Microscopic activity predicts relapse in patients with distal ulcerative colitis on 4-aminosalicylate enemas.  Gastroenterology. 1988;  96 A151 (III)
  • 3 Riley S A, Mani V, Goodman M J, Dutt S, Herd M E. Microscopic activity in ulcerative colitis: What does it mean?.  Gut. 1991;  32 174-178 (II b)
  • 4 Ardizzone S, Petrillo M, Imbesi V. et al . Is maintenance therapy always necessary for patients with ulcerative colitis in remission?.  Aliment Pharmacol Ther. 1999;  13 373-379 (I b)
  • 5 Kornbluth A A, Salomon P, Sacks H S, Mitty R, Janowitz H D. Meta-analysis of the effectiveness of current drug therapy of ulcerative colitis.  J Clin Gastroenterol. 1993;  16 215-218 (I a)
  • 6 Sutherland L R, Roth D E, Beck P L. Alternatives to sulfasalazine: A meta-analysis of 5-ASA in the treatment of ulcerative colitis.  Inflamm Bowel Dis. 1997;  3 65-78 (I a)
  • 7 Sutherland L R, May G R, Shaffer E A. Sulfasalazine revisited: A meta-analysis of 5-ASA in the treatment of ulcerative colitis.  Ann Intern Med. 1993;  118 540-549 (I a)
  • 8 Marshall J K, Irvine E J. Rectal aminosalicylate therapy for distal ulcerative colitis: A meta-analysis.  Aliment Pharmacol Ther. 1995;  9 293-300 (I a)
  • 9 D’Albasio G, Pacini F, Camarri E. et al . Combined therapy with 5-aminosalicylic acid tablets and enemas for maintaining remission in ulcerative colitis: A randomized double-blind study.  Am J Gastroenterol. 1997;  92 1143-1147 (I a)
  • 10 Riley S A. What dose of 5-aminosalicylic acid (mesalazine) in ulcerative colitis?.  Gut. 1998;  42 761-763
  • 11 Azad Khan A K, Howes D T, Piris J, Truelove S C. Optimum dose of sulphasalazine for maintenance treatment in ulcerative colitis.  Gut. 1980;  21 232-240 (I b)
  • 12 Fockens P, Mulder C JJ, Tytgat G NJ, Blok P, Ferwerda J. and the Dutch Pentasa Study Group . Comparison of the efficacy and safety of 1.5 compared with 3.0 g oral slow- release mesalazine (Pentasa) in the maintenance treatment of ulcerative colitis.  Eur J Gastroenterol Hepatol. 1995;  7 1025-1030 (I b)
  • 13 Kiilerich S, Ladefoged K, Rannem T, Ranlov P J. and the Dutch olsalazine study group . Prophylactic effects of olsalazine v sulphasalazine during 12 months maintenance treatment of ulcerative colitis.  Gut. 1992;  33 252-255 (I b)
  • 14 Biddle W L, Greenberger N J, Swan J T, McPhee M S, Miner P B. 5-Aminosalicylic acid enemas: Effective agent in maintaining remission in left-sided ulcerative colitis.  Gastroenterology. 1988;  94 1075-1079 (I b)
  • 15 Mantzaris G J, Hatzis A, Petraki K, Spilladi C, Triantaphyllou G. Intermittent therapy with high-dose 5-aminosalicylic acid enemas maintains remission in ulcerative proctitis and proctosigmoiditis.  Dis Colon Rectum. 1994;  37 58-62 (I b)
  • 16 D’Albasio G, Trallori G, Ghetti A. et al . Intermittent therapy with high dose 5-aminosalicylic acid enemas for maintaining remission in ulcerative proctosigmoiditis.  Dis Colon Rectum. 1990;  33 394-397 (I b)
  • 17 D’Albasio G, Paoluzi P, Campieri M. et al, and the Italian IBD study group . Maintenance treatment of ulcerative proctitis with mesalazine suppositories: A double-blind placebo-controlled trial.  Am J Gastroenterol. 1998;  93 799-803 (I b)
  • 18 Marteau P, Crand J, Foucault M, Ramboud J C. Use of mesalazine slow release suppositories 1 g three times per week to maintain remission of ulcerative proctitis: A randomised double blind placebo controlled multicentre study.  Gut. 1998;  42 195-199 (I b)
  • 19 Sandborn W J. Azathioprine: State of the art in inflammatory bowel disease.  Scand J Gastroenterol. 1998;  33 92-99 (Suppl. 225)
  • 20 Kruis W, Schütz E, Fric P. et al . Double-blind comparison of an oral Escherichia coli preparation and mesalazine in maintaining remission of ulcerative colitis.  Aliment Pharmacol Ther. 1997;  11 853-858 (I b)
  • 21 Rembacken B J, Snelling A M, Hawkey P M, Chalmers D M, Axon A TR. Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: A randomised trial.  Lancet. 1999;  354 635-639 (I b)
  • 22 Fernández-Banares F, Hinojosa J, Sánchez-Lombrana J L. et al and the Spanish group for the study of Crohn’s disease and ulcerative colitis (GETECCU) . Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission of ulcerative colitis.  Am J Gastroenterol. 1999;  94 427-433 (I b)
  • 23 Pinczowski D, Ekbom A, Baron J, Yuen J, Adami H -O. Risk factors for colorectal cancer in patients with ulcerative colitis: A case control study.  Gastroenterology. 1994;  107 117-120 (III)
  • 24 Moody G A, Jayanthi V, Probert C SJ, Mac Kay H, Mayberry J F. Long-term therapy with sulphasalazine protects against colorectal cancer in ulcerative colitis: A retrospective study of colorectal cancer risk and compliance with treatment in Leicestershire.  Eur J Gastroenterol Hepatol. 1996;  8 1179-1183 (III)