Däbritz Jan, Classen Martin, Krohn Kathrin, Krahl Andreas, Buderus Stephan, Lainka Elke, de Laffolie Jan, Posovszky Carsten
Universitätsmedizin Greifswald Klinik und Poliklinik für Kinder und Jugendmedizin, Greifswald, Deutschland.
Kinder- und Jugendklinik, Klinikum Westbrandenburg, Potsdam, Deutschland.
Z Gastroenterol. 2025 Mar;63(3):255-268. doi: 10.1055/a-2474-3104. Epub 2025 Feb 17.
Therapy for children and adolescents with chronic inflammatory bowel disease (IBD) is basically no different from that for adult patients. However, of the steadily increasing number of biologics and signalling inhibitors for adults, only two TNFα antibodies are currently approved in Germany for the treatment of IBD from the age of 6. This means that a large proportion of the drugs authorised for adults with IBD are not available for children and adolescents with moderate to severe disease. The small number of approved drugs also makes it difficult to achieve the prognostically important goal of achieving a sustained remission of IBD soon after diagnosis, which is characterised by the patient being free of symptoms and also the objectifiable goal of mucosa healing. This position paper is intended to present the current study situation on the drug treatment of children and adolescents with IBD outside the age limit and to serve as a basis for information and decision-making for the Medical Service in the assessment of individual case applications as well as for the treating physicians, the cost bearers, health policy and social court decision-makers.
儿童和青少年慢性炎症性肠病(IBD)的治疗与成人患者基本无异。然而,在成人使用的生物制剂和信号抑制剂数量不断增加的情况下,德国目前仅批准两种TNFα抗体用于治疗6岁及以上儿童的IBD。这意味着,许多获批用于成人IBD的药物无法用于患有中重度疾病的儿童和青少年。获批药物数量较少也使得难以实现IBD诊断后尽快实现持续缓解这一具有重要预后意义的目标,持续缓解的特征是患者无症状,且实现黏膜愈合这一可客观化的目标。本立场文件旨在介绍IBD儿童和青少年超出年龄限制的药物治疗的当前研究情况,并作为医疗服务机构评估个别病例申请以及治疗医生、费用承担方、卫生政策和社会法院决策者信息和决策的依据。