Universität zu Köln

Kruis, Wolfgang, Nguyen, Phuong G. and Morgenstern, Julia (2017). Promises and Dangers of Combination Therapy. Dig. Dis., 35 (1-2). S. 56 - 61. BASEL: KARGER. ISSN 1421-9875

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Abstract

The efficiency of the existing methods of treating inflammatory bowel disease (IBD) is limited. There are 2 ways to address this problem either create new treatment modalities or optimize current therapies. Optimisation may be accomplished by using combinations of established therapeutic strategies. With regard to topically acting compounds such as 5-aminosalicylic acid, combining oral and rectal preparations is a commonly used method. Another commonly used combination is anti-tumor necrosis factor (TNF)-alpha antibody modalities together with immunosuppressants (thiopurines, methotrexate). Several aspects favour those combinations such as increased effectivity, prevention of immunogenicity and perhaps less adverse events. Currently, discussion on directly additive therapeutic effects is in progress, which have been demonstrated in some clinical trials. As on date, the combination of infliximab with azathioprine is most likely the most effective treatment of Crohn's disease. On the other hand, a combination therapy with both compounds affecting the immune system has, of course, risks. For sure, the frequency with which serious infectious complications are arising is increasing. Furthermore, the number of patients experiencing malignancies such as hepato-splenic lymphoma or melanoma is strongly suspected to be on the rise. In summary, combinations of current treatments for IBD are widely established. Various strategies have been studied and significant improvements of therapeutic effects have been demonstrated. Unfortunately, some of those proven combinations increase therapeutic risks, for example, increase the frequency of serious infections and also of some malignancies. Therefore, great caution has to be exercised when applying combination therapies. (C) 2017 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kruis, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Nguyen, Phuong G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Morgenstern, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-247409
DOI:	10.1159/000449084
Journal or Publication Title:	Dig. Dis.
Volume:	35
Number:	1-2
Page Range:	S. 56 - 61
Date:	2017
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1421-9875
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INFLAMMATORY-BOWEL-DISEASE; CROHNS-DISEASE; ULCERATIVE-COLITIS; PERIANAL FISTULAS; DOUBLE-BLIND; AZATHIOPRINE; REMISSION; MONOTHERAPY; INFLIXIMAB; METHOTREXATE Multiple languages Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24740