Treatment Strategies in Inflammatory Bowel Diseases
Stallmach A, Atreya R, Grunert PC, Stallhofer J, de Laffolie J, Schmidt C (2023)
Publication Type: Journal article, Review article
Publication year: 2023
Journal
Book Volume: 120
Pages Range: 768-778
Journal Issue: 45
DOI: 10.3238/arztebl.m2023.0142
Abstract
BACKGROUND: The prevalence of inflammatory bowel disease (IBD) is rising globally. In Germany, these conditions affect 0.7% of the population, or approximately 600 000 patients. Treatment strategies have become more diversified as a result of an improved understanding of disease pathogenesis. It remains unclear how the currently available drugs should best be used in each individual patient. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed, with special attention to phase III and IV trials and to the German and European guidelines on the treatment of IBD. RESULTS: An improved understanding of the immunological mechanisms of disease underlies the current treatment strategies in patients with IBD. For those with a complex clinical course, monoclonal antibodies against pro-inflammatory cytokines (TNF, IL-12/IL-23, IL-23) and cell adhesion molecules (α4β7) are of established therapeutic value, along with "small molecules" such as JAK inhibitors and sphingosine-1-phosphate receptor modulators. The numerous studies that have been performed, only a few of which have been head-to-head comparison trials, and the (network) meta-analyses that have been published to date do not imply that any single one of these drugs can be considered the universal, primary treatment for all patients with IBD. In this review, we discuss the available substances and certain important differential-therapeutic aspects of the treatment of IBD. CONCLUSION: The treatment of a patient with IBD must take his or her prior treatment(s) and comorbidities into account, along with individual patient characteristics and treatment goals. Rational decision-making is required on the basis of the mechanism of action and the side-effect profile of the various drugs that are now available for use.
Authors with CRIS profile
Raja Atreya
Professur für Translationale Immunforschung bei chronisch entzündlichen Darmerkrankungen (Heisenberg-Professur)
Involved external institutions
Justus-Liebig-Universität Gießen
Germany (DE)
Universitätsklinikum Jena
Germany (DE)
Philipps-Universität Marburg
Germany (DE)
Germany (DE)
Universitätsklinikum Jena
Germany (DE)
Philipps-Universität Marburg
Germany (DE)
How to cite
APA:
Stallmach, A., Atreya, R., Grunert, P.C., Stallhofer, J., de Laffolie, J., & Schmidt, C. (2023). Treatment Strategies in Inflammatory Bowel Diseases. Deutsches Ärzteblatt international, 120(45), 768-778. https://dx.doi.org/10.3238/arztebl.m2023.0142
MLA:
Stallmach, Andreas, et al. "Treatment Strategies in Inflammatory Bowel Diseases." Deutsches Ärzteblatt international 120.45 (2023): 768-778.
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