Biologicals in der Gastroenterologie am Beispiel der Anti-TNF-Antikörper

Zusammenfassung

Anti-TNF-Antikörper stellen eine weit verbreitete Option für die Behandlung von chronisch-entzündlichen Darmerkrankungen dar. Obwohl sie bei vielen Patienten erfolgreich eingesetzt werden, können sie auch erhebliche Nebenwirkungen verursachen, wie etwa bakterielle oder virale Infektionen. Deshalb muss vor ihrer Anwendung die Patientenanamnese eingehend geprüft werden. Zudem muss der Gesundheitszustand des Patienten sowohl vor Beginn als auch während einer Therapie mit Anti-TNF-Antikörpern sorgfältig kontrolliert werden. Weiterhin zeigen wir im vorliegenden Artikel Möglichkeiten auf, wie auf einen Wirkverlust der Anti-TNF-Antikörper reagiert werden kann, beispielsweise mittels Dosissteigerung oder einer Re-Induktionstherapie.

Abstract

TNF-blockers represent a well accepted therapeutic option in the treatment of inflammatory bowel disease. Though they are successfully used in many patients, they can also exert severe side effects, such as infectious diseases. Therefore, a careful review of the patient history as well as a continuous evaluation of the patient’s state of health is crucial before starting an anti-TNF therapy during the therapeutic treatment. In addition, we review also the possibilities by loss of efficacy of an anti-TNF therapy, such as dose increase or re-induction therapy.

chronisch-entzündliche Darmerkrankungen - Morbus Crohn - Colitis ulcerosa - TNF-Blocker - Biologica

inflammatory bowel disease - Crohn’s disease - ulcerative colitis - TNF-blocker - biologicals

Literatur

• 1 Akobeng A K, Zachos M. Tumor necrosis factor-alpha antibody for induction of remission in CrohnŽs disease.  Cochrane Database Syst Rev. 2004;  (1CD003574)
• 2 Allez M, Vermeire S, Mozziconacci N. et al . The efficacy and safety of a third anti-TNF monoclonal antibody in Crohn’s disease after failure of two other anti-TNF antibodies.  Aliment Pharmacol Ther. 2010;  31 92-101
• 3 Baert F, Noman M, Vermeire S. et al . Influence of immunogenicity on the long-term efficacy of infliximab in Crohn’s disease.  N Engl J Med. 2003;  34 601-608
• 4 Cepeda E J, Williams F M, Ishimori M L. et al . The use of anti-tumour necrosis factor therapy in HIV-positive individuals with rheumatic disease.  Ann Rheum Dis. 2008;  67 710-2
• 5 Colombel J F, Sandborn W J, Reinisch W. et al . Infliximab, azathioprine, or combination for CrohnŽs disease.  N Engl J Med. 2010;  362 1383-1395
• 6 Colombel J F, Schwartz D A, Sandborn W J. et al . Adalimumab for the treatment of fistulas in patients with CrohnŽs disease.  Gut. 2009;  58 940-948
• 7 Colombel J F, Sandborn W J, Panaccione R. et al . Adalimumab safety in global clinical trial of patients with Crohn’s disease.  Inflamm Bowel Dis. 2009;  15 1308-1319
• 8 Feagan B. et al . A randomized trial of methotrexate in combination with infliximab for the treatment of Crohn’s disease.  Gut. 2008;  5 (Suppl II) A66
• 9 Hanauer S B, Feangan B G, Lichtenstein G R. et al . Maintenance infliximab for Crohn’s disease: the ACCENT I randomised trial.  Lancet. 2002;  359 1541-1549
• 10 Hanauer S B, Wagner C L, Bala M. et al . Incidence and importance of antibody responses to infliximab after maintenance or episodic treatment in Crohn’s disease.  Clin Gastroenterol Hepatol. 2004;  2 542-553
• 11 Karmiris K, Paintaud G, Noman M. et al . Influence of trough serum levels and immunogenicity on long-term outcome on adalimumab therapy in CrohnŽs disease.  Gastroenterology. 2009;  137 1628-40
• 12 Karmiris K. et al . A 3-week course of 80 mg weekly administered adalimubab as a rescue therapy for patients with Crohn’s disease who lost response to 40 mg weekly: relationships with adalimubab trough serum levels.  Gastroenterology. 2008;  134 A640
• 13 Lichtenstein G, Feagan B F, Cohen R D. et al . Serious infections and mortality in association with therapies for Crohn’s disease: TREAT registry.  Clin Gastroenterol Hepatol. 2006;  4 621-30
• 14 Louis E. et al . Infliximab discontinuation in CrohnŽs disease patients in stable remission on combined therapy with immunosuppressors: a prospective ongoing cohort study (STORI).  Gastroenterology. 2009;  134 A–961
• 15 Lügering A, Schmidt M, Lügering N. et al . Infliximab induced apoptosis in monocytes from patients with chronic active Crohn’s disease by using a caspase-dependent pathway.  Gastroenterology. 2001;  134 1242-6
• 16 Nathan D, Angus P P, Gibson R. Hepatitis B and C virus infections and anti-tumor necrosis factor-α therapy: Guidelines for clinical approach.  J Gastroenterl Hepatol. 2006;  21 1366-71
• 17 Naveau S, Chollet-Martin S, Dharancy S. et al . A double-blind randomized controlled trial of infliximab associated with prednisolone in acute alcoholic hepatitis.  Hepatology. 2004;  39 1390-7
• 18 Ochenrider M G, Patterson D J, Aboulafia D M. Hepatosplenic T-cell lymphoma in a young man with CrohnŽs disease: Case report and literature review.  Clin Lymphoma Myeloma Leuk. 2010;  10 144-8
• 19 Plosker G L, Lyseng-Williamson K A. Adalimumab: in CrohnŽs disease.  BioDrugs. 2007;  21 125-32
• 20 Rutgeerts P J. Review article: efficacy of infliximab in CrohnŽs disease – induction and maintenance of remission.  Aliment Pharmacol Ther. 1999;  13 Suppl 4 9-15
• 21 Rutgeerts P, Feagan B G, Lichtenstein G R. et al . Comparison of scheduled and episodic treatment strategies of infliximab in Crohn’s disease.  Gastroenterology. 2004;  126 402-413
• 22 Sandborn W. et al . Benefits of dosage adjustment with adalimubab in Crohn’s disease: an analysis of the CHARM trial.  Gastroenterology. 2008;  134 (Suppl 1) A347
• 23 Sands B E, Anderson F H, Bernstein C N. et al . Infliximab maintenance for fistulising CrohnŽs disease.  N Engl J Med. 2004;  350 876-885
• 24 Schnitzler F, Fidder H, Ferrante M. et al . Long-term outcome of treatment with infliximab in 614 patients with Crohn’s disease: results from a single-center cohort.  Gut. 2009;  5 492-500
• 25 Shen C, Assche G V, Colpaert S. et al . Adalimumab induces apoptosis of human monocytes: a comparative study with infliximab and etanercept.  Aliment Pharmacol Ther. 2005;  21 251-258
• 26 Stallmach A, Hagel S, Bruns T. Adverse effects of biologics used for treating IBD.  Best Pract Res Clin Gastroenterol. 2010;  24 167-182
• 27 Van Assche G, Magdelaine-Beuzelin C. et al . Withdrawal of immunosuppression in Crohn’s disease treated with scheduled infliximab maintenance: a randomized trial.  Gastroenterology. 2008;  134 1861-1868
• 28 Vasiliauskas E, Church J A, Silverman N. et al . Case Report: Evidence for Transplacental Transfer of Maternally Administered Infliximab to the Newborn.  Clin Gastroenterol Hepatol. 2006;  4 1255-1258
• 29 Vieira A, Fang C B, Rolim E G. et al . Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes.  BMC Res Notes. 2009;  2 221
• 30 Wilhelm S M, McKenney K A, Rivait K N, Kale-Pradhan P B. A review of Infliximab Use in Ulcerative Colitis.  Clinical Therapeutics. 2008;  30 223-230