Nieuwe inzichten en behandelingen bij IBD

Presentatie over: "Nieuwe inzichten en behandelingen bij IBD"— Transcript van de presentatie:

1 Nieuwe inzichten en behandelingen bij IBD
Dr Peter Bossuyt Gastroenterologie IBD kliniek Bonheiden

2

3 Hetzelfde maar anders Anders en beter Wat nu?
Optimalisatie van de behandeling Anders en beter Nieuwe behandelingen

4 Hetzelfde maar anders 5-ASA Steroiden Purine-analogen
Single dose versus split dose Steroiden “lokaal” werkende versus systemische steroiden Purine-analogen Imuran versus Puri-Nethol

5 Hetzelfde maar anders Anti-TNF (remicade & humira) Mono versus combo
Antistof vorming Effectiviteit Duur? Vroeg- versus laattijdig

6 Hetzelfde maar anders Anti-TNF (remicade & humira) Through levels

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

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

9 Anders en beter Anti-inflammatoir

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

11 Besluit