152 153 Intestinal Disease Meeting Berlin 2006 - Dr. Falk Pharma ...

More documents

Recommendations

Info

Session 3 Conventional Immunomodulator Therapy Chair: W.E. Fleig, Leipzig M. Lémann, Paris 34 Increasing importance of immunomodulators Alongside the standard medications, immunomodulators, such as azathioprine, have been gaining increased importance in the treatment of IBD, said S.P.L. Travis (Oxford). Azathioprine is indicated when, after a severe disease flare, patients require treatment with steroids multiple times within one year, if the disease recurs while patients are on steroids or within three months of their discontinuance, and also for postoperative prophylaxis of Crohn’s disease. Fig. 23 Remission induced by prednisolone; tapered over 12 weeks Patients not failing trial [%] 100 80 60 40 20 Steroids + azathioprine Azathioprine S.P.L. Travis Studies show that azathioprine is significantly more effective than placebo for maintenance of remission (figure 23). Usually, the agent is administered when patients are either refractory to, or dependent on, steroids. Azathioprine is also the agent in this class with the most clinical experience. Only after it has been shown to be ineffective does the focus shift to the other immunomodulators, such as methotrexate. Placebo (n = 30) Azathioprine 2.5 mg/kg bw/day (n = 33) 0 0 15 Duration of trial [Months] Candy et al. Gut 1995, 37: 674 I Azathioprine for maintaining clinical remission in Crohn’s disease after steroid induction (S.P.L. Travis, Oxford)
Optimize clinical efficacy, minimize risks It is important to remember, said J.-F. Colombel (Lille), that therapy with immunosuppressants has specific side effects, such as a significantly increased risk of infection (figure 24). This is less pronounced with the clinically established immunosuppressants, such as azathioprine, whose side effects are well known, than with the biologics now flooding the market. “The risk of side Fig. 24 Herpes simplex CMV Varicella zoster EBV HPV Congress Short Report <strong>Falk</strong> Symposium J.-F. Colombel M. Lémann M. tuberculosis M. avium sp. M. xenopi Listeria monocytogenes Staphylococcus sp. Nocardia E. coli Salmonella sp. I Infections associated with immunomodulator therapy in IBD (J.-F. Colombel, Lille) effects associated with these substances must not be underestimated. We must do all we can to optimize clinical efficacy and reduce the risks of these substances secondary to their toxicity,” J.-F. Colombel advised. Because of their clinical efficacy, immunosuppressants such as azathioprine and also methotrexate are being used earlier in the clinical course of IBD. They are indicated in chronic active disease and also for postoperative prophylaxis of disease recurrence, said Histoplasmosis Aspergillus spp. Cryptococcus spp. Candida spp. Coccidioides immitis Blastomyces Pneumocystis jiroveci Toxoplasma gondii <strong>153</strong> 35
Page 1 and 2: Intestinal Disease Meeting Berlin 2
Page 3 and 4: Falk Symposium 152 Endoscopy 2006 -
Page 5 and 6: Falk Symposium 152 Endoscopy 2006 -
Page 7 and 8: (Düsseldorf) cited the development
Page 9 and 10: New techniques are in development
Page 11 and 12: Endoscopy - It also has therapeutic
Page 13 and 14: Pancreatobiliary endoscopy in thera
Page 15 and 16: Session 2 Role of Endoscopy Chair:
Page 17 and 18: Fig. 13 Diagnosis: Crohn’s diseas
Page 19 and 20: Accurate work-up of pseudocysts Acc
Page 21 and 22: Session 4 Gastrointestinal Oncology
Page 23 and 24: Congress Short Report Falk Symposiu
Page 25 and 26: Live Demonstration Endoscopy 2006 -
Page 27 and 28: Interview Interview with Professor
Page 29 and 30: Session 1 Congress Short Report Fal
Page 31 and 32: Congress Short Report Falk Symposiu
Page 33 and 34: Session 2 Optimization in Therapy T
Page 35: Fig. 22 CDP571 34 21 Placebo I CRP
Page 39 and 40: Fig. 26 % of relapse 70 60 50 40 30
Page 41 and 42: J. Schölmerich Only a minority of
Page 43 and 44: State-of-the-Art-Lecture State-of-t
Page 45 and 46: Promising results with helminths Th
Page 47 and 48: T. Andus (Bad Cannstatt). The princ
Page 49 and 50: Session 6 New Therapeutic Approache
Page 51 and 52: Fig. 35 Wound healing Infections Ti
Page 53 and 54: Index Chairpersons, Speakers and Sc
Page 55 and 56: Prof. Dr. S. Jonas Allgemein- und V
Page 57 and 58: Dr. S. Vermeire Univ. Ziekenhuis Ga
Page 60: FALK FOUNDATION e.V. Leinenweberstr

152 153 Intestinal Disease Meeting Berlin 2006 - Dr. Falk Pharma ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?