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F\u00fcnf\u00a0Klassen fortgeschrittener Therapien stehen zur Verf\u00fcgung.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Ziel der Arbeit<\/jats:title>\n            <jats:p>Praxisnahe \u00dcbersicht \u00fcber fortgeschrittene Therapien bei CED.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methoden<\/jats:title>\n            <jats:p>Narrativer Review.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Ergebnisse und Diskussion<\/jats:title>\n            <jats:p>Fortgeschrittene Therapien sind bei mittel- bis schwerer CED indiziert. Der fr\u00fchzeitige Einsatz wird empfohlen, um bessere Ansprechraten zu erreichen und eine irreversible, strukturelle Darmsch\u00e4digung zu vermeiden. Tumor-Nekrose-Faktor(TNF)- und Januskinase(JAK)-Inhibitoren sind breit wirksam, auch bei extraintestinalen Krankheitsmanifestationen. Unter JAK-Inhibitoren ist das Risiko einer Varicella-zoster-Virus-Reaktivierung erh\u00f6ht. Bei Hochrisikopatienten und im Alter\u202f&gt;\u200965\u00a0Jahre besteht ein moderat erh\u00f6htes Risiko kardiovaskul\u00e4rer und neoplastischer Nebenwirkungen. Der Integrin-\u03b14\u03b27-Hemmer Vedolizumab und der Interleukin(IL)-12\/-23-Inhibitor Ustekinumab haben ein sehr gutes Sicherheitsprofil. Selektive IL-23-Hemmer sind Ustekinumab bei vergleichbarem Sicherheitsprofil bez\u00fcglich der Wirksamkeit teilweise \u00fcberlegen. Die Sphingosin-1-Phosphat-Rezeptormodulatoren Ozanimod und Etrasimod sind als orale Therapien bei Colitis ulcerosa zugelassen. Unver\u00e4ndert sind die Therapieerfolge der Medikamente begrenzt; auf jede individuelle Therapie wird eine Minderheit der Patienten nicht ansprechen. Dies erfordert oft die sequenzielle Gabe mehrerer Therapien. Aufgrund fehlender Vergleichsstudien erfolgen personalisierte Therapieauswahl, -sequenz und -entscheidung oft gem\u00e4\u00df pers\u00f6nlicher Erfahrung; sie sollten u.\u202fa. Patientenpr\u00e4ferenz, Wirksamkeit, Sicherheit und individuelle Patientenprofile ber\u00fccksichtigen.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00108-024-01833-w","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T01:40:22Z","timestamp":1735868422000},"page":"3-14","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anwendung fortgeschrittener Therapien bei chronisch-entz\u00fcndlichen Darmerkrankungen","Application of advanced treatment in chronic inflammatory bowel diseases"],"prefix":"10.1007","volume":"66","author":[{"given":"Benjamin","family":"Misselwitz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Zei\u00dfig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Schreiber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel","family":"Dignass","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"1833_CR1","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1055\/a-2271-0994","volume":"62","author":"T Kucharzik","year":"2024","unstructured":"Kucharzik\u00a0T, Dignass\u00a0A, Atreya\u00a0R et\u00a0al (2024) Aktualisierte Leitlinie Colitis ulcerosa (Version 6.2). 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