Topische Anwendung von TNF-Blockern

Zusammenfassung

Im Jahr 1998 wurde der erste TNF-Blocker in den USA und ein Jahr später auch in Deutschland zugelassen. Die Therapie mit TNF-Blockern hat die Therapiemöglichkeiten von Patienten mit chronisch-entzündlichen Erkrankungen in Rheumatologie, Dermatologie und Gastroenterologie deutlich erweitert. Es ist aber nicht immer möglich, durch systemisch applizierte TNF-Blocker eine lokale klinische Besserung der jeweiligen Grundkrankheit zu erreichen. Daher gab es in den letzten Jahren vielfältige Ansätze einer topischen Therapie mit TNF-Blockern. Das wichtigste Ziel dieser off-label-Anwendungen ist die Applikation einer größeren Menge des TNF-Blockers im entzündeten Gewebe, als dies mit einer systemischen Therapie erreichbar wäre. Diese Übersicht gibt einen Überblick über die Vielfalt der bislang erfolgten topischen Therapieversuche mit TNF-Blockern.

Abstract

In 1998, the first TNF-blocker was approved in the USA and a year later in Germany. Treatment with TNF-blocking agents has significantly expanded therapeutic options for patients with chronic inflammatory diseases in rheumatology, dermatology and gastroenterology. However, it is not always possible to achieve a local clinical improvement by systemically administered TNF-blockers. Many approaches to topical therapy with TNF blockers have been published in recent years. The main objective of these off-label applications is the injection of a larger quantity of TNF-blocker in the inflamed tissue than it is achievable with systemic therapy. This summary provides an overview of the variety of topical therapy trials and reports own experiences in patients with Crohn's disease.

Schlüsselwörter

Infliximab - Etanercept - Adalimumab - M. Crohn - rheumatoide Arthritis - Ischialgie - ankylosierende Spondylitis - Osteoarthritis - Uveitis

Keywords

Infliximab - Etanercept - Adalimumab - Crohn’s disease - rheumatoid arthritis - sciatica - ankylosing spondylitis - osteoarthritis - uveitis

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