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Nieuwe inzichten en behandelingen bij IBD

Nieuwe inzichten en behandelingen bij IBD. Dr Peter Bossuyt Gastroenterologie IBD kliniek Bonheiden. Wat nu?. Hetzelfde maar anders. 5-ASA Single dose versus split dose Steroiden “ lokaal ” werkende versus systemische steroiden Purine-analogen Imuran versus Puri-Nethol.

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Nieuwe inzichten en behandelingen bij IBD

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  1. Nieuwe inzichten en behandelingen bij IBD Dr Peter Bossuyt Gastroenterologie IBD kliniekBonheiden

  2. Wat nu?

  3. Hetzelfdemaaranders • 5-ASA • Single dose versus split dose • Steroiden • “lokaal” werkende versus systemischesteroiden • Purine-analogen • Imuran versus Puri-Nethol

  4. Hetzelfdemaaranders • Anti-TNF (remicade& humira) • Mono versus combo • Antistofvorming • Effectiviteit • Duur? • Vroeg- versus laattijdig

  5. Hetzelfdemaaranders • Anti-TNF (remicade & humira) • Through levels

  6. Biologicals Type: Cytokine/chemokine ABT-874/J695/Abbott CertolizumabCelltech-UCB HuMxIL15/Genmab VT-214/ Viron rIL18 BP/ Merck Serono MDX-1100/ Medarex C326/Avidia Tocilizumab (atlizumab)/Chugai Infliximab/Centocor/MSD CCX282-B /ChemoCentryx Natalizumab/Elan/Biogen Apilimod mesylate (STA5236)/Syntha Adhesion molecules Hematopoietic stem cell transpl/ (ASTic) Anti-TNF B Lymphocytes N1-0401-01/ NovImmune Visilizumab/Nuvion T Lymphocytes Abatacept/Bristol-Mayers Others PF-00547,659 Rituximab/Roche AntiCD103/ LigoCyte Adalimumab/Abbott Opebacan/Xoma Basiliximab/ Cerimon Ch5D12/Tanox Thymosin beta4/ RegeneRx AntiVAP1/BioTie Vedolizumab (MLN0002)/ Millenium AIN457/novartis Ustekinumab (CNTO 1275)/ Centocor rhuMab beta7/Genentech Launch Phase III Phase II Phase I Pre-clinic smad7/ Giuliani THC:CBD/GW Pharmaceuticals IPL42/ Inflazyme NV52/ Novogen Guanilib/Callisto CP-690,550/Pfizer Revlimid/Celgene LaquinimodTheva Small molecules

  7. Anders en beter • Anti-adhesie Slow down roll Integrinesbecomeactivated tethering diapedesis chemokine-receptor a4b7-integrin chemokines L-selectin MadCAM-1 CCX282-B Chemocentryx CCR9 Natalizumab (Antegren), Vedolizumab (Millennium), PF-00547659 MadCam, rhuMab-beta7 Genentech, human a4b7 Amgen

  8. Anders en beter • Anti-inflammatoir

  9. Conditioning Infusion ATG Cyclo L R Conditioning Infusion ATG Cyclo Cyclo G-CSF Post-mobilisation Phase Pre-mobilisation Phase Mobilisation Phase Year 1 Year 2 Conditioning and Transplantation Phase Group A Conditioning and Transplantation Phase Group B M0 M12 M6 (days) PM0 PM34 PM28 (days) T0 T54 T106 T52 (weeks) Anders en beter • Stam cell transplantatie endoxan endoxan endoxan

  10. Besluit

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