Therapieresistente

Therapieresistent, or therapy-resistant, is a term used in medicine to describe diseases or conditions that do not respond adequately to standard treatments. It implies insufficient clinical improvement or disease progression despite appropriate therapy, administered at correct doses and for an appropriate duration. The concept is applied across fields such as oncology, infectious diseases, rheumatology, and psychiatry. It is distinct from treatment intolerance, where therapy cannot be used due to adverse effects.

There are two main types of resistance. Primary (intrinsic) resistance refers to lack of expected response from the outset, while acquired (secondary) resistance develops after an initial period of partial or complete response. Mechanisms are varied and can include genetic or molecular changes that negate a drug’s effect, alterations in drug delivery or metabolism, adaptive changes in the disease environment, or adherence problems. Infections may involve resistant pathogens; cancers may harbor resistant cell clones or reside in protective microenvironments; autoimmune or inflammatory diseases may require different targets or combination strategies.

Diagnosis often involves re-evaluating the initial diagnosis, reassessing disease activity, checking medication adherence, and sometimes performing biomarkers or imaging to distinguish true resistance from other causes of nonresponse. Management strategies include switching or adding therapies, combination regimens, dose optimization, enrollment in clinical trials, or pursuing non-pharmacological options where appropriate.

Prognosis varies by condition and context, but therapy resistance generally poses a challenge and typically prompts more individualized or innovative treatment approaches.