[IBD ahead 2010--Answering important questions in Crohn's disease treatment]

Z Gastroenterol. 2011 Sep;49(9):1246-54. doi: 10.1055/s-0031-1273416. Epub 2011 Aug 24.
[Article in German]

Abstract

The treatment of patients with inflammatory bowel disease has become more complex in recent years through the introduction of various immunosuppressive agents as well as the approval of monoclonal antibodies against TNF-α and patients receiving such treatment must be carefully monitored. National and international guidelines define a diagnostic and therapeutic context for the practitioner, but can only partially respond to specific questions on the procedure for individual patients. Within the framework of a project initiated by Abbott entitled "IBD ahead" 38 German IBD experts have elaborated concrete proposals for dealing with corticosteroids, immunosuppressants and TNF-α antibodies on the basis of the published literature and their own personal experience in order to close the gap between these guidelines and daily clinical practice. Statements were developed on the choice of correct timing of initiation, dose and duration of the individual substances and on how to proceed with patients exhibiting treatment failure. Moreover, recommendations are also made on drug combination strategies, safety monitoring and the risks regarding the development of infectious complications and malignancies. These recommendations are illustrated by case studies from everyday practice in participating centres.

Publication types

  • English Abstract
  • Practice Guideline

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use
  • Crohn Disease / complications
  • Crohn Disease / immunology
  • Crohn Disease / therapy*
  • Drug Interactions
  • Drug Therapy, Combination
  • Gastrointestinal Agents / adverse effects
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Irritable Bowel Syndrome / chemically induced
  • Irritable Bowel Syndrome / drug therapy
  • Treatment Failure
  • Tumor Necrosis Factor-alpha / immunology

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Monoclonal
  • Gastrointestinal Agents
  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha