Inzwischen steht eine Vielzahl an Medikamenten zur Behandlung eines Morbus Crohn zur
Verfügung, deren Therapieziele von klinischer Symptomkontrolle bis hin zu mukosaler
Heilung reichen. Die Chancen steigen, dass Morbus-Crohn-Patienten in Remission bleiben.
Allerdings sind die Medikamente nicht bei allen Patient*innen langfristig wirksam.
Oft treten Sättigungseffekte ein, die die Therapie unwirksam machen. Der folgende
Beitrag gibt einen Überblick über die neuesten und die zeitnah zu erwartenden Therapieoptionen
bei Morbus Crohn.
Abstract
Crohn’s disease is a chronic inflammatory bowel disease (IBD) that can manifest throughout
the entire gastrointestinal tract from mouth to anus. It is characterized by so-called
“skip lesions”, which are affected sections of the intestine interspersed with healthy
sections. In recent years, there have been significant progress and an expansion of
medical treatment options for Crohn’s disease with the approval of many new substances.
Treatment goals have also become more ambitious, going beyond clinical symptom control
to mucosal healing and, according to the STRIDE II criteria, to transmural healing
in Crohn’s disease in the future. If these goals are achieved, patients with Crohn’s
disease have a good chance of remaining in long-term remission and can expect fewer
complications such as disease progression, hospitalization, anemia, fistulas, strictures,
or surgeries. Despite having access to a variety of different substance classes in
the treatment of Crohn’s disease, in everyday practice we can see that these medications
are not effective for some patients in the long-term. There is a so-called “therapeutic
ceiling” in IBD, meaning that only about 40–50% of those affected are successfully
managed long-term with one substance. Therefore, new medical treatment options for
Crohn’s disease always represent an opportunity to treat patients even better.
Schlüsselwörter
Morbus Crohn - Colitis ulcerosa - Therapieoptionen - kleine Moleküle - Biologika
Keywords
Crohn`s diesease - ulcerative colitis - advanced therapies - small molecules - biologics
