Therapy of inflammatory bowel diseases over the past two decades

Czech version

Authors: M. Bortlík
Authors‘ workplace: Klinické a výzkumné centrum pro střevní záněty ISCARE I. V. F. a. s. a Interní klinika 1. LF UK a ÚVN, Praha
Published in: Gastroent Hepatol 2015; 69(4): 341-350
Category:

Overview

The therapy of inflammatory bowel diseases (IBD) has substantially changed over the past two decades, mostly because of the introduction of biologic agents. Whereas aminosalicylates still remain the major drug for ulcerative colitis, their role in Crohn’s disease has however become negligible. Thiopurines dominate in long‑term maintenance therapy of IBD, especially in Cronh’s desease; they also play an important role in combined therapy with anti‑TNF antibodies. Systemic steroids still remain an important and highly effective drug for severely active IBD. Budesonide is a clearly weaker, topical variant with no effect in maintenance therapy. Whereas biologic therapy, namely anti‑TNF antibodies, are currently at the top of the therapeutic pyramid, vedolizumab, a promising representative of the new class of integrin antibodies has recently been registered, and is expected to be marketed soon in the Czech Republic. Surgical therapy is an inseparable part of IBD treatment. Current management of IBD is based on individualized and tailored therapy, and aimed at treatment that targets: the elimination of the risk of irreversible structural changes and repeated surgeries with disabling consequences for the patient.

Key words:
inflammatory bowel disease – ulcerative colitis – Crohn’s disease – therapy

Sources

1. Burisch J, Jess T, Martinato M et al. The burden of inflammatory bowel disease in Europe. J Crohns Colitis 2013; 7(4): 322– 337. doi: 10.1016/ j.crohns.2013.01.010.

2. Stange EF, Travis SP, Vermeire S et al. European evidence‑based consensus on the diagnosis and management of ulcerative colitis: definitions and diagnosis. J Crohns Colitis 2008; 2(1): 1– 23. doi: 10.1016/ j.crohns.2007.11.001.

3. Prokopová L, Ďuricová D, Bortlík M et al. Doporučené postupy pro podávání aminosalicylátů u nemocných s idiopatickými střevními záněty. Gastroent Hepatol 2012; 66(5): 391– 400.

4. Dignass AU, Bokemeyer B, Adamek Het al. Mesalamine once daily is more effective than twice daily in patients with quiescent ulcerative colitis. Clin Gastroenterol Hepatol 2009; 7(7): 762– 769. doi: 10.1016/ j.cgh.2009.04.004.

5. Kruis W, Kiudelis G, Racz I et al. Once daily versus three times daily mesalazine granules in active ulcerative colitis: a double‑blind, double‑dummy, randomised, non‑inferiority trial. Gut 2009; 58(2): 233– 240. doi: 10.1136/ gut.2008.154302.

6. Schreiber S, Kamm MA, Lichtenstein GR. Mesalamine with MMX technology for the treatment of ulcerative colitis. Expert Rev Gastroenterol Hepatol 2008; 2(3): 299– 314. doi: 10.1586/ 17474124.2.3.299.

7. Sandborn WJ, Travis S, Moro L et al. Once‑ daily budesonide MMX® extended‑ release tablets induce remission in patients with mild to moderate ulcerative colitis: results from the CORE I study. Gastroenterology 2012; 143(5): 1218– 1226.e1– 2. doi: 10.1053/ j.gastro.2012.08.003.

8. Travis SP, Danese S, Kupcinskas L et al. Once‑ daily budesonide MMX in active, mild‑ to‑ moderate ulcerative colitis: results from the randomised CORE II study. Gut 2014; 63(3): 433– 441. doi: 10.1136/ gutjnl‑ 2012‑ 304258.

9. Gisbert JP, Linares PM, McNicholl AG et al. Meta‑analysis: the efficacy of azathioprine and mercaptopurine in ulcerative colitis. Aliment Pharmacol Ther 2009; 30(2): 126– 137. doi: 10.1111/ j.1365‑ 2036.2009.04023.x.

10. Rutgeerts P, Sandborn WJ, Feagan BG et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 2005; 353(23): 2462– 2476.

11. Bortlík M, Ďuricová D, Kohout P et al. Doporučení pro podávání biologické terapie u idiopatických střevních zánětů: 2. vydání. Gastroent Hepatol 2012; 66(1): 12– 22.

12. Feagan BG, Rutgeerts P, Sands BE et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 2013; 369(8): 699– 710. doi: 10.1056/ NEJMoa1215734.

13. Bortlík M. Vedolizumab – nová antiintegrinová protilátka s vysokou gastrointestinální selektivitou. Gastroent Hepatol 2014; 68(6): 481– 484. doi: 10.14735/ amgh2014481.

14. Lukáš M. Vedolizumab v léčbě ulcerózní kolitidy. Gastroent Hepatol 2015; 69(1): 29– 32. doi:10.14735/ amgh201529.

15. Lukáš M. Současnost a budoucnost v léčbě ulcerózní kolitidy. Gastroent Hepatol 2013; 67(3): 212– 218.

16. Torres J, Billioud V, Sachar D et al. Ulcerative colitis as a progressive disease: the forgotten evidence. Inflamm Bowel Dis 2012; 18(7): 1356– 1363. doi: 10.1002/ ibd.22839.

17. Malíčková K, Bortlík M, Ďuricová D et al. Vliv albuminemie na farmakokinetiku infliximabu u nemocných s idiopatickými střevními záněty. Gastroent Hepatol 2011; 65(2): 70– 74.

18. Gibson DJ, Heetun ZS, Redmond CE et al. An accelerated infliximab induction regimen reduces the need for early colectomy in patients with acute severe ulcerative colitis. Clin Gastroenterol Hepatol 2015; 13(2): 330– 335. doi: 10.1016/ j.cgh.2014.07.041.

19. Øresland T, Bemelman WA, Sampietro GM et al. European evidence based consensus on surgery for ulcerative colitis. J Crohns Colitis 2015; 9(1): 4– 25. doi: 10.1016/ j.crohns.2014.08.012.

20. Murphy PB, Khot Z, Vogt KN et al. Quality of life after total proctocolectomy with ileostomy or IPAA: a systematic review. Dis Colon Rectum 2015; 58(9): 899– 908. doi: 10.1097/ DCR.0000000000000418.

21. Lukáš M. Současnost a budoucnost v léčbě Crohnovy nemoci. Gastroent Hepatol 2013; 67(4): 306– 312.

22. Travis SP, Stange EF, Lemann M et al. European evidence based consensus on the diagnosis and management of Crohn’s disease: current management. Gut 2006; 55 (Suppl 1): i16– i35. doi: 10.1136/ gut.2005.081950b.

23. Duricova D, Pedersen N, Elkjaer Met al. 5- aminosalicylic acid dependency in Crohn‘s disease: a Danish Crohn Colitis Database study. J Crohns Colitis 2010; 4(5): 575– 581. doi: 10.1016/ j.crohns.2010.06.002.

24. Dignass A, Van Assche G, Lindsay JO et al. The second European evidence‑based Consensus on the diagnosis and management of Crohn‘s disease: current management. J Crohns Colitis 2010; 4(1): 28– 62. doi: 10.1016/ j.crohns.2009.12.002.

25. Pearson DC, May GR, Fick GH et al. Azathioprine and 6- mercaptopurine in Crohn disease. A meta‑analysis. Ann Intern Med 1995; 123(2): 132– 142.

26. Prefontaine E, Sutherland LR, Macdonald JK et al. Azathioprine or 6- mercaptopurine for maintenance of remission in Crohn‘s disease. Cochrane Database Syst Rev 2009; 1: CD000067. doi: 10.1002/ 14651858.CD000067.pub2.

27. Panés J, López‑ Sanromán A, Bermejo F et al. Early azathioprine therapy is no more effective than placebo for newly diagnosed Crohn‘s disease. Gastroenterology 2013; 145(4): 766– 774. doi: 10.1053/ j.gastro.2013.06.009.

28. Cosnes J, Bourrier A, Laharie D et al. Early administration of azathioprine vs conventional management of Crohn‘s disease: a randomized controlled trial. Gastroenterology 2013; 145(4): 758– 765. doi: 10.1053/ j.gastro.2013.04.048.

29. Hoentjen F, Seinen ML, Hanauer SB et al. Safety and effectiveness of long‑term allopurinol‑ thiopurine maintenance treatment in inflammatory bowel disease. Inflamm Bowel Dis 2013; 19(2): 363– 369. doi: 10.1002/ ibd.23021.

30. Bortlík M. Současný pohled na léčbu perianálních píštělí u nemocných s Crohnovou chorobou. Gastroent Hepatol 2013; 67(1): 25– 29.

31. Yarur AJ, Kubiliun MJ, Czul F et al. Concentrations of 6- thioguanine nucleotide correlate with trough levels of infliximab in patients with inflammatory bowel disease on combination therapy. Clin Gastroenterol Hepatol 2015; 13(6): 1118– 1124. doi: 10.1016/ j.cgh.2014.12.026.

32. Osterman MT, Kundu R, Lichtenstein GR et al. Association of 6- thioguanine nucleotide levels and inflammatory bowel disease activity: a meta‑analysis. Gastroenterology 2006; 130(4): 1047– 1053.

33. Kopylov U, Al‑ Taweel T, Yaghoobi M et al. Adalimumab monotherapy versus combination therapy with immunomodulators in patients with Crohn‘s disease: a systematic review and meta‑analysis. J Crohns Colitis 2014; 8(12): 1632– 1641. doi: 10.1016/ j.crohns.2014.07.003.

34. Vande Casteele N, Ferrante M, Van Assche G et al. Trough concentrations of infliximab guide dosing for patients with inflammatory bowel disease. Gastroenterology 2015; 148(7): 1320– 1329. doi: 10.1053/ j.gastro.2015.02.031.

35. Louis E, Mary JY, Vernier‑ Massouille G et al. Maintenance of remission among patients with Crohn‘s disease on antimetabolite therapy after infliximab therapy is stopped. Gastroenterology 2012; 142(1): 63– 70. doi: 10.1053/ j.gastro.2011.09.034.

36. Bortlik M, Duricova D, Machkova N et al. Discontinuation of anti‑tumor necrosis factor therapy in inflammatory bowel disease patients: a prospective observation. Scand J Gastroent 2015. Accepted Manuscript ID: 1079924.

37. Molnár T, Lakatos PL, Farkas K et al. Predictors of relapse in patients with Crohn‘s disease in remission after 1 year of biological therapy. Aliment Pharmacol Ther 2013; 37(2): 225– 233. doi: 10.1111/ apt.12160.

38. Brooks AJ, Sebastian S, Cross SS et al.Outcome of elective withdrawal of anti‑-tumour necrosis factor‑ a therapy in patients with Crohn‘s disease in established remission. J Crohns Colitis 2015. In press. doi: 10.1016/ j.crohns.2014.09.007.

39. Regueiro M, Schraut W, Baidoo L et al. Infliximab prevents Crohn’s disease recurrence after ileal resection. Gastroenterology 2009; 136(2): 441– 450. doi: 10.1053/ j.gastro.2008.10.051.

40. Herfarth HH. Anti‑tumor necrosis factor therapy to prevent Crohn‘s disease recurrence after surgery. Clin Gastroenterol Hepatol 2014; 12(9): 1503– 1506. doi: 10.1016/ j.cgh.2014.02.014.

41. Reguiero M, Feagan BG, Zou B et al. Infliximab for Prevention of Recurrence of Post‑Surgical Crohn‘s Disease Following Ileocolonic Resection: A Randomized, Placebo‑ Controlled Study. Gastroenterology 2015; 148(4): S‑ 141.

42. De Cruz P, Kamm MA, Hamilton AL et al. Crohn‘s disease management after intestinal resection: a randomised trial. Lancet 2015; 385(9976): 1406– 1417. doi: 10.1016/ S0140‑ 6736(14)61908‑ 5.

43. Šerclová Z, Ryska O, Bortlík M et al. Doporučené postupy chirurgické léčby pacientů s idiopatickými střevními záněty – 2. část: Crohnova nemoc. Gastroent Hepatol 2015; 69(3): 223– 238. doi: 10.14735/ amgh2015223.

44. Lakatos PL, Golovics PA, David G et al. Has there been a change in the natural history of Crohn‘s disease? Surgical rates and medical management in a population‑based inception cohort from Western Hungary between 1977– 2009. Am J Gastroenterol 2012; 107(4): 579– 588. doi: 10.1038/ ajg.2011.448.

45. Ramadas AV, Gunesh S, Thomas GA et al. Natural history of Crohn‘s disease in a population‑based cohort from Cardiff (1986– 2003): a study of changes in medical treatment and surgical resection rates. Gut 2010; 59(9): 1200– 1206. doi: 10.1136/ gut.2009.202101.

46. Rungoe C, Langholz E, Andersson Met al. Changes in medical treatment and surgery rates in inflammatory bowel disease: a nationwide cohort study 1979– –2011. Gut 2014; 63(10): 1607– 1616. doi: 10.1136/ gutjnl‑ 2013‑ 305607.