Die Colitis ulcerosa (CU) repräsentiert eine der zwei Hauptformen der chronisch entzündlichen Darmerkrankungen (CED). In Deutschland sind etwa 160.000 Patient*innen von dieser Erkrankung betroffen [1]
[2]. Da sich die CU gehäuft in jüngeren Lebensjahren manifestiert und sich die Lebenserwartung über alle Patient*innen gesehen nur wenig von der gesunden Normalbevölkerung unterscheidet, leidet ein großer Teil der Patient*innen lebenslang an den teilweise schwerwiegendsten Symptomen der Erkrankung. Wesentliche Symptome der CU beinhalten Bauchschmerzen, häufig blutige Durchfälle, imperativer Stuhldrang, teilweise Stuhlinkontinenz, Wachstumsverzögerung oder ausbleibendes Wachstum bei Kindern, Leistungsminderung, vielfältige Mangelerscheinungen sowie ein großes Spektrum von extraintestinalen Nebenwirkungen wie Gelenkbeschwerden, Augenentzündungen, Hautveränderungen und Leberbeteiligung [1]
[2]. Dies führt zu hohen volkswirtschaftlichen Folgekosten bedingt durch Arbeitsausfall, Folgeoperationen und psychischer Beeinträchtigung bedingt durch die Krankheitsfolgen sowie verminderter Lebensqualität verbunden mit sozialer Isolation, eingeschränkten Möglichkeiten in der beruflichen Entwicklung mit teilweise vorzeitiger Berentung sowie auch in der persönlichen Familienplanung [3]
[4]
[5]. Die Anzahl an Patient*innen mit CU hat weltweit und auch in Deutschland in den letzten Jahrzehnten zugenommen [6].
Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
Literatur
1
Kucharzik T,
Koletzko S,
Kannengiesser K.
et al. Ulcerative Colitis-Diagnostic and Therapeutic Algorithms. Deutsches Arzteblatt international 2020; 117: 564-574
3
Dubinsky MC,
Dotan I,
Rubin DT.
et al. Burden of comorbid anxiety and depression in patients with inflammatory bowel disease: a systematic literature review. Expert review of gastroenterology & hepatology 2021; 15: 985-997
4
Daperno M,
Armuzzi A,
Danese S.
et al. Unmet Medical Needs in the Management of Ulcerative Colitis: Results of an Italian Delphi Consensus. Gastroenterology research and practice 2019; 2019: 3108025
5
Almario CV,
Ballal ML,
Chey WD.
et al. Burden of Gastrointestinal Symptoms in the United States: Results of a Nationally Representative Survey of Over 71,000 Americans. The American journal of gastroenterology 2018; 113: 1701-1710
6
Ng SC,
Shi HY,
Hamidi N.
et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet 2017; 390: 2769-2778
8
Annese V,
Beaugerie L,
Egan L.
et al. European Evidence-based Consensus: Inflammatory Bowel Disease and Malignancies. Journal of Crohnʼs & colitis 2015; 9: 945-965
9
Kucharzik T,
Ellul P,
Greuter T.
et al. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. Journal of Crohnʼs & colitis 2021; 15: 879-913
10
Gisbert JP,
Marin AC,
Chaparro M.
The Risk of Relapse after Anti-TNF Discontinuation in Inflammatory Bowel Disease: Systematic Review and Meta-Analysis. Am J Gastroenterol 2016; 111: 632-647
11
Hanauer SB,
Feagan BG,
Lichtenstein GR.
et al. Maintenance infliximab for Crohn's disease: the ACCENT I randomised trial. Lancet 2002; 359: 1541-1549
12
Colombel JF,
Sandborn WJ,
Rutgeerts P.
et al. Adalimumab for maintenance of clinical response and remission in patients with Crohnʼs disease: the CHARM trial. Gastroenterology 2007; 132: 52-65
13
Schreiber S,
Khaliq-Kareemi M,
Lawrance IC.
et al. Maintenance therapy with certolizumab pegol for Crohnʼs disease. The New England journal of medicine 2007; 357: 239-250
15
Sands BE,
Sandborn WJ,
Panaccione R.
et al. Ustekinumab as Induction and Maintenance Therapy for Ulcerative Colitis. The New England journal of medicine 2019; 381: 1201-1214
16
Sandborn WS,
D'Haens G.
Efficacy and safety of oral tofacitinib as induction therapy in patients with moderate to severe ulcerative colitis: results from two phase 3 randomized controlled trials. Gastroenterology 2016; S157
18
Feagan BG,
Rubin DT,
Danese S.
et al. Efficacy of Vedolizumab Induction and Maintenance Therapy in Patients With Ulcerative Colitis, Regardless of Prior Exposure to Tumor Necrosis Factor Antagonists. Clin Gastroenterol Hepatol 2017; 15: 229-239.e5
19
Sandborn WJ,
Feagan BG,
D'Haens G.
et al. Ozanimod as Induction and Maintenance Therapy for Ulcerative Colitis. The New England journal of medicine 2021; 385: 1280-1291
20
Selinger CP,
Andrews JM,
Titman A.
et al. Long-term follow-up reveals low incidence of colorectal cancer, but frequent need for resection, among Australian patients with inflammatory bowel disease. Clin Gastroenterol Hepatol 2014; 12: 644-650
21
Williet N,
Sarter H,
Gower-Rousseau C.
et al. Patient-reported Outcomes in a French Nationwide Survey of Inflammatory Bowel Disease Patients. Journal of Crohnʼs & colitis 2017; 11: 165-174
22
Armuzzi A,
Liguori G.
Quality of life in patients with moderate to severe ulcerative colitis and the impact of treatment: A narrative review. Digestive and liver disease: official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2021; 53: 803-808
23
Rubin DT,
Sninsky C,
Siegmund B.
et al. International Perspectives on Management of Inflammatory Bowel Disease: Opinion Differences and Similarities Between Patients and Physicians From the IBD GAPPS Survey. Inflammatory bowel diseases 2021; 27: 1942-1953
24
Armuzzi A,
DiBonaventura MD,
Tarallo M.
et al. Treatment patterns among patients with moderate-to-severe ulcerative colitis in the United States and Europe. PloS one 2020; 15: e0227914
25
Turner D,
Ricciuto A,
Lewis A.
et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology 2021; 160: 1570-1583
27
Sands BE,
Armuzzi A,
Marshall JK.
et al. Efficacy and safety of tofacitinib dose de-escalation and dose escalation for patients with ulcerative colitis: results from OCTAVE Open. Alimentary pharmacology & therapeutics 2020; 51: 271-280
28
Combe B,
Kivitz A,
Tanaka Y.
et al. Filgotinib versus placebo or adalimumab in patients with rheumatoid arthritis and inadequate response to methotrexate: a phase III randomised clinical trial. Annals of the rheumatic diseases 2021; 80: 848-858
29
Westhovens R,
Rigby WFC,
van der Heijde D.
et al. Filgotinib in combination with methotrexate or as monotherapy versus methotrexate monotherapy in patients with active rheumatoid arthritis and limited or no prior exposure to methotrexate: the phase 3, randomised controlled FINCH 3 trial. Annals of the rheumatic diseases 2021;
