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Neue Biologika für die Behandlung chronisch-entzündlicher Darmerkrankungen

New biologics for treatment of chronic inflammatory bowel diseases

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Zusammenfassung

Hintergrund

Die Therapie der chronisch-entzündlichen Darmerkrankungen hat sich in den letzten Jahrzehnten deutlich weiterentwickelt. Dennoch besteht ein Bedarf an Medikamenten für eine bessere, langfristige Kontrolle des Entzündungsprozesses.

Stand der Entwicklung

Neue Biologika gegen das Adhäsionsmolekül α4β7-Integrin (Vedolizumab) und gegen das Zytokin Interleukin-23 (Ustekinumab) stehen vor der Zulassung, nachdem in großen Therapiestudien die Effizienz bei Colitis ulcerosa bzw. Morbus Crohn gezeigt werden konnte. Weitere Biologika gegen Adhäsionsmoleküle und Elemente des Interleukin-6-Signalwegs befinden sich in der klinischen Entwicklung.

Schlussfolgerung

Mit der Entwicklung neuer Biologika wird sich das therapeutische Spektrum für die chronisch-entzündlichen Darmerkrankungen erweitern. Wünschenswert wäre eine Standortbestimmung. So müssen die Interaktionen neuer Behandlungsoptionen mit bestehenden Therapieverfahren wie der Anti-TNF-α-Therapie untersucht werden. Des Weiteren sind neue Effizienzparameter für die langfristige Krankheitskontrolle wünschenswert.

Abstract

Background

The therapeutic options for chronic inflammatory bowel diseases have seen an enormous development over the last decades. However, there are several unmet needs which warrant the development of additional biologics for a better and complete control of the inflammatory process.

State of development

Novel biological therapies that will be approved in the near future include blockade of the adhesion molecule integrin alpha4beta7 and the cytokine interleukin 23. Large phase III trials have established the clinical efficacy in ulcerative colitis and Crohn’s disease, respectively. The development of biologic therapies in earlier stages includes additional antibodies that block adhesion molecules as well as biologics that intercept the interleukin 6 pathway.

Conclusion

The therapeutic landscape in inflammatory bowel disease will be enriched by additional biologic therapies. Clinical studies should investigate the interaction with existing therapies, e.g. anti-tumor necrosis factor (TNF) therapies and the development of new endpoints for a better disease control and for improved long-term outcome.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. S. Schreiber hat Einladungen zu Vorträgen angenommen oder an Beratungsstunden teilgenommen, die von folgenden pharmazeutischen Firmen unterstützt wurden: AbbVie, Amgen, AstraZeneca, Bayer Schering, Bristol-Myers Squibb, Falk, Ferring, Merck, Novartis, Pfizer, Sanofi, Takeda. O. Bachmann hat Einladungen zu Vorträgen angenommen oder an Beratungsstunden teilgenommen, die von folgenden pharmazeutischen Firmen unterstützt wurden: AbbVie, Falk, Ferring, MSD, Takeda. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik für Innere Medizin I, Universitätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Schittenhelmstr. 12, 24105, Kiel, Deutschland

    S. Schreiber

  2. Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover, Deutschland

    O. Bachmann

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Schreiber, S., Bachmann, O. Neue Biologika für die Behandlung chronisch-entzündlicher Darmerkrankungen. Internist 55, 367–376 (2014). https://doi.org/10.1007/s00108-013-3415-4

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