Prävention bei chronisch entzündlichen Darmerkrankungen

Stefanie Tischendorf; Maximilian Hatting

doi:10.1055/a-1317-2680

Der Klinikarzt, Table of Contents

Der Klinikarzt 2020; 49(12): 538-544
DOI: 10.1055/a-1317-2680

Schwerpunkt

Prävention bei chronisch entzündlichen Darmerkrankungen

Von Anämie bis Osteoporose

Stefanie Tischendorf

¹Klinik für Gastroenterologie, Stoffwechselerkrankungen und Internistische Intensivmedizin (Medizinische Klinik III), Universitätsklinikum Aachen

,

Maximilian Hatting

¹Klinik für Gastroenterologie, Stoffwechselerkrankungen und Internistische Intensivmedizin (Medizinische Klinik III), Universitätsklinikum Aachen

› Author Affiliations

Abstract

ZUSAMMENFASSUNG

Patienten mit chronisch entzündlichen Erkrankungen (CED) wie Morbus Crohn und Colitis ulcerosa haben spezielle Bedürfnisse im Bereich Vorsorge und Prävention. Grunderkrankung und Therapie können in verschiedenen Bereichen zu erhöhter Morbidität führen. Blutbildveränderungen durch chronischen Blutverlust und Substratmangel oder Eisenverwertungsstörungen sind häufig. Steroidtherapie und Malnutrition können zu Osteopenie und Osteoporose führen. Hier sind CED-Patienten, insbesondere im Alter, gefährdet. Das Erkennen von Mangelzuständen und die Optimierung der Therapie sind entscheidend, um hier präventiv tätig zu werden. Gleiches gilt für das Erkennen von Impflücken und die richtige Risikostratifizierung der häufig immunsupprimierten Patienten. Zuletzt ist auch die Tumorvorsorge von Bedeutung, da sowohl durch die Grunderkrankung als auch durch die Therapie ein erhöhtes Malignomrisiko bestehen kann.

Full Text

References

Literatur
1 Gasche C. Anemia in IBD: the overlooked villain. Inflamm Bowel Dis 2000; 6: 142-150 discussion 151
2 Kulnigg S, Gasche C. Systematic review: managing anaemia in Crohn’s disease. Aliment Pharmacol Ther 2006; 24: 1507-1523
3 Gisbert JP, Gomollón F. Common misconceptions in the diagnosis and management of anemia in inflammatory bowel disease. Am J Gastroenterol 2008; 103: 1299-1307
4 Stein J, Hartmann F, Dignass AU. Diagnosis and management of iron deficiency anemia in patients with IBD. Nat Rev Gastroenterol Hepatol 2010; 7: 599-610
5 Gomollón F, Gisbert JP. Anemia and inflammatory bowel diseases. World J Gastroenterol 2009; 15: 4659-4665
6 WHO, UNICEF, UNU. Iron Deficiency Anemia: Assessment, Prevention and Control. Report of a joint WHO/UNICEF/UNU consultation. 1998
7 Wilson A, Reyes E, Ofman J. Prevalence and outcomes of anemia in inflammatory bowel disease: a systematic review of the literature. Am J Med 2004; 116 (Suppl. 07) A: 44S-49S
8 Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med 2005; 352: 1011-1023
9 Gasche C, Lomer MCE, Cavill I. et al Iron, anaemia, and inflammatory bowel diseases. Gut 2004; 53: 1190-1197
10 Bergamaschi G, Di Sabatino A, Albertini R. et al Prevalence and pathogenesis of anemia in inflammatory bowel disease. Influence of anti-tumor necrosis factor-alpha treatment. Haematologica 2010; 95: 199-205
11 Wiesen A, Wiesen J, Limaye S. et al Mesalazine-induced aplastic anemia. The American Journal of Gastroenterology 2009; 104: 1063
12 Otsubo H, Kaito K, Sekita T. et al Mesalazine-associated severe aplastic anemia successfully treated with antithymocyte globulin, cyclosporine and granulocyte colony-stimulating factor. Int J Hematol 1998; 68: 445
13 van Hees. Hemolysis during salicylazosulfapyridine therapy. Am J Gastroenterol 1978; 70: 501
14 Dignass AU, Gasche C, Bettenworth D. et al European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases. J Crohns Colitis 2015; 9: 211-222
15 Biggar P, Hahn K-M. Bedeutung der verschiedenen i.v.-Eisengenerationen für den medizinischen Alltag. MMW 2013; 155 (Suppl. 01) 18-24
16 Evstatiev R, Marteau P, Iqbal T. et al FERGIcor, a randomized controlled trial on ferric carboxymaltose for iron deficiency anemia in inflammatory bowel disease. Gastroenterology 2011; 141: 846-853.e1-2
17 Gasche C. Prediction of response to iron sucrose in inflammatory bowel disease-associated anemia. Am J Gastroenterol 2001; 96: 2382-2387
18 Gasché C, Dejaco C, Waldhoer T. et al Intravenous iron and erythropoietin for anemia associated with Crohn disease. A randomized, controlled trial. Ann Intern Med 1997; 126: 782-787
19 Evstatiev R, Alexeeva O, Bokemeyer B. et al Ferric carboxymaltose prevents recurrence of anemia in patients with inflammatory bowel disease. Clin Gastroenterol Hepatol 2013; 11: 269-277
20 Reinisch W, Staun M, Tandon RK. et al A randomized, open-label, non-inferiority study of intravenous iron isomaltoside 1,000 (Monofer) compared with oral iron for treatment of anemia in IBD (PROCEED). Am J Gastroenterol 2013; 108: 1877-1888
21 Koutroubakis IE, Oustamanolakis P, Karakoidas C. et al Safety and efficacy of total-dose infusion of low molecular weight iron dextran for iron deficiency anemia in patients with inflammatory bowel disease. Dig Dis Sci 2010; 55: 2327-2331
22 Khalil A, Goodhand JR, Wahed M. et al Efficacy and tolerability of intravenous iron dextran and oral iron in inflammatory bowel disease: a case-matched study in clinical practice. Eur J Gastroenterol Hepatol 2011; 23: 1029-1035
23 Geisser P, Baer M, Schaub E. Structure/histotoxicity relationship of parenteral iron preparations. Arzneimittelforschung 1992; 42: 1439
24 Favrat B, Balck K, Breymann C. et al Evaluation of a single dose of ferric carboxymaltose in fatigued, iron-deficient women--PREFER a randomized, placebo-controlled study. PLoS ONE 2014; 9: e94217
25 Kulnigg S, Stoinov S, Simanenkov V. et al A novel intravenous iron formulation for treatment of anemia in inflammatory bowel disease: the ferric carboxymaltose (FERINJECT) randomized controlled trial. Am J Gastroenterol 2008; 103: 1182-1192
26 Schröder O, Mickisch O, Seidler U. et al Intravenous iron sucrose versus oral iron supplementation for the treatment of iron deficiency anemia in patients with inflammatory bowel disease--a randomized, controlled, open-label, multicenter study. Am J Gastroenterol 2005; 100: 2503-2509
27 Silva AD de, Tsironi E, Feakins RM. et al Efficacy and tolerability of oral iron therapy in inflammatory bowel disease: a prospective, comparative trial. Aliment Pharmacol Ther 2005; 22: 1097-1105
28 Finch C. Regulators of iron balance in humans [see comments]. Blood 1994; 84: 1697-1702
29 Evstatiev R, Gasche C. Iron sensing and signalling. Gut 2012; 61: 933-952
30 Gasche C, Ahmad T, Tulassay Z. et al Ferric Maltol is Effective in Correcting Iron Deficiency Anemia in Patients with Inflammatory Bowel Disease: results from a Phase-3 Clinical Trial Program. Inflamm Bowel Dis 2015; 21: 579-588
31 Kulnigg S, Teischinger L, Dejaco C. et al Rapid recurrence of IBD-associated anemia and iron deficiency after intravenous iron sucrose and erythropoietin treatment. Am J Gastroenterol 2009; 104: 1460-1467
32 Cronin CC, Shanahan F. Anemia in patients with chronic inflammatory bowel disease. Am J Gastroenterol 2001; 96: 2296-2298
33 Nissenson AR, Wade S, Goodnough T. et al Economic burden of anemia in an insured population. J Manag Care Pharm 2005; 11: 565
34 Gasche C, Berstad A, Befrits R. et al Guidelines on the diagnosis and management of iron deficiency and anemia in inflammatory bowel diseases. Inflamm Bowel Dis 2007; 13: 1545-1553
35 García-Erce JA, Gomollón F, Muñoz M. Blood transfusion for the treatment of acute anaemia in inflammatory bowel disease and other digestive diseases. World J Gastroenterol 2009; 15: 4686-4694
36 Villanueva C, Colomo A, Bosch A. et al Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013; 368: 11-21
37 Hébert PC, Wells G, Blajchman MA. et al A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N Engl J Med 1999; 340: 409-417
38 Bager P, Dahlerup JF. The health care cost of intravenous iron treatment in IBD patients depends on the economic evaluation perspective. J Crohns Colitis 2010; 4: 427-430
39 Braun J, van der Heijde D, Doyle MK. et al Improvement in hemoglobin levels in patients with ankylosing spondylitis treated with infliximab. Arthritis Rheum 2009; 61: 1032-1036
40 Leo Carnerero E, Aoufi S, Montero Cuadrado I. et al Autoimmune hemolytic anemia associated with ulcerative colitis: response to infliximab. Am J Gastroenterol 2009; 104: 2370-2371
41 Domènech E, Mañosa M, Masnou H. et al Infliximab for the treatment of chronic anemia in Crohn’s disease. Am J Gastroenterol 2005; 100: 496
42 Abitbol V, Roux C, Chaussade S. et al Metabolic bone assessment in patients with inflammatory bowel disease. Gastroenterology 1995; 108: 417-422
43 Bernstein CN, Leslie WD, Leboff MS. AGA technical review on osteoporosis in gastrointestinal diseases. Gastroenterology 2003; 124: 795-841
44 Pollak RD, Karmeli F, Eliakim R. et al Femoral neck osteopenia in patients with inflammatory bowel disease. Am J Gastroenterol 1998; 93: 1483-1490
45 Vestergaard P. Prevalence and pathogenesis of osteoporosis in patients with inflammatory bowel disease. Minerva medica 2004; 95: 469-480
46 Ali T, Lam D, Bronze MS. et al Osteoporosis in inflammatory bowel disease. Am J Gastroenterol 2009; 122: 599-604
47 Targownik LE, Bernstein CN, Nugent Z. et al Inflammatory bowel disease has a small effect on bone mineral density and risk for osteoporosis. Clin Gastroenterol Hepatol 2013; 11: 278-285
48 van Staa TP, Leufkens HG, Abenhaim L. et al Use of oral corticosteroids in the United Kingdom. QJM 2000; 93: 105-111
49 Preiß JC, Bokemeyer B, Buhr HJ. et al Aktualisierte S3-Leitlinie--“Diagnostik und Therapie des Morbus Crohn“ 2014. Z Gastroenterol 2014; 52: 1431-1484
50 Selby L, Kane S, Wilson J. et al Receipt of preventive health services by IBD patients is significantly lower than by primary care patients. Inflamm Bowel Dis 2008; 14: 253-258
51 Teich N, Klugmann T, Tiedemann A. et al Vaccination coverage in immunosuppressed patients: results of a regional health services research study. Dtsch Arztebl Int 2011; 108: 105-111
52 Marehbian J, Arrighi HM, Hass S. et al Adverse events associated with common therapy regimens for moderate-to-severe Crohn’s disease. Am J Gastroenterol 2009; 104: 2524-2533
53 Foster KJ, Devitt N, Gallagher PJ. et al Overwhelming pneumococcal septicaemia in a patient with ulcerative colitis and splenic atrophy. Gut 1982; 23: 630-632
54 van der Hoeven JG, Koning J de, Masclee AM. et al Fatal pneumococcal septic shock in a patient with ulcerative colitis. Clin Infect Dis 1996; 22: 860-861
55 Ritz MA, Jost R. Severe pneumococcal pneumonia following treatment with infliximab for Crohn’s disease. Inflamm Bowel Dis 2001; 7: 327
56 Cullen G, Bader C, Korzenik JR. et al Serological response to the 2009 H1N1 influenza vaccination in patients with inflammatory bowel disease. Gut 2012; 61: 385-391
57 Nguyen DL, Nguyen ET, Bechtold ML. Effect of Immunosuppressive Therapies for the Treatment of Inflammatory Bowel Disease on Response to Routine Vaccinations: A Meta-Analysis. Dig DisSci 2015; 60: 2446-2453
58 Farraye FA, Melmed GY, Lichtenstein GR. et al ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease. Am J Gastroenterol 2017; 112: 241-258
59 Rahier J-F, Papay P, Salleron J. et al H1N1 vaccines in a large observational cohort of patients with inflammatory bowel disease treated with immunomodulators and biological therapy. Gut 2011; 60: 456-462
60 Dotan I, Werner L, Vigodman S. et al Normal response to vaccines in inflammatory bowel disease patients treated with thiopurines. Inflamm Bowel Dis 2012; 18: 261-268
61 Singh S, Nagpal SJS, Murad MH. et al Inflammatory bowel disease is associated with an increased risk of melanoma: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2014; 12: 210-218
62 Long MD, Martin CF, Pipkin CA. et al Risk of melanoma and nonmelanoma skin cancer among patients with inflammatory bowel disease. Gastroenterology 2012; 143: 390-399.e1
63 Ramsay HM, Reece SM, Fryer AA. et al Seven-year prospective study of nonmelanoma skin cancer incidence in U. K. renal transplant recipients. Transplantation 2007; 84: 437-439
64 Pedersen N, Duricova D, Elkjaer M. et al Risk of extra-intestinal cancer in inflammatory bowel disease: meta-analysis of population-based cohort studies. Am J Gastroenterol 2010; 105: 1480-1487
65 Peyrin-Biroulet L, Khosrotehrani K, Carrat F. et al Increased risk for nonmelanoma skin cancers in patients who receive thiopurines for inflammatory bowel disease. Gastroenterology 2011; 141: 1621-28.e1-5
66 Singh H, Nugent Z, Demers AA. et al Increased risk of nonmelanoma skin cancers among individuals with inflammatory bowel disease. Gastroenterology 2011; 141: 1612-1620
67 Ariyaratnam J, Subramanian V. Association between thiopurine use and nonmelanoma skin cancers in patients with inflammatory bowel disease: a meta-analysis. Am J Gastroenterol 2014; 109: 163-169
68 Abbas AM, Almukhtar RM, Loftus EV. et al Risk of melanoma and non-melanoma skin cancer in ulcerative colitis patients treated with thiopurines: a nationwide retrospective cohort. Am J Gastroenterol 2014; 109: 1781-1793
69 Sokol H, Beaugerie L. Inflammatory bowel disease and lymphoproliferative disorders: the dust is starting to settle. Gut 2009; 58: 1427-1436
70 [Anonymous]. Aktualisierte S3-Leitlinie Colitis ulcerosa der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – AWMF-Register-Nr. 021/009. Z Gastroenterol 2019; 57: 162-241
71 Annese V, Daperno M, Rutter MD. et al European evidence based consensus for endoscopy in inflammatory bowel disease. J Crohns Colitis 2013; 7: 982-1018