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Review
. 2022 Feb 18;11(4):1076.
doi: 10.3390/jcm11041076.

Selecting the Best Combined Biological Therapy for Refractory Inflammatory Bowel Disease Patients

Eduard Brunet Mas  1   2   3 , Xavier Calvet Calvo  1   2   3
Affiliations
Review

Selecting the Best Combined Biological Therapy for Refractory Inflammatory Bowel Disease Patients

Eduard Brunet Mas et al. J Clin Med. .

Abstract

Current medical treatment for inflammatory bowel disease (IBD) does not achieve 100% response rates, and a subset of refractory and severely ill patients have persistent active disease after being treated with all possible drug alternatives. The combination of two biological therapies (CoT) seems a reasonable alternative, and has been increasingly tested in very difficult cases. The present review suggests that CoT seems to be safe and effective for refractory and severely ill IBD patients. Ustekinumab plus vedolizumab and vedolizumab plus anti-TNF were the most used CoTs for Crohn's disease. For ulcerative colitis, the most used CoTs were vedolizumab plus anti-TNF and vedolizumab plus tofacitinib. The aforesaid CoTs have shown good efficacy and few adverse events have been reported.

Keywords: Crohn’s disease; biologic treatment; combination; inflammatory bowel diseases; ulcerative colitis.

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Conflict of interest statement

Xavier Calvet has received grants for research from Abbvie, MSD, Janssen, and Vifor, and fees for advisory boards and lecturer services form Abbvie MSD, Takeda, and Vifor. He and has also given lectures for Abbvie, MSD, Takeda, Shire, and Allergan. Eduard Brunet has no conflict of interest.

Figures

Figure 1
Figure 1
Percentage of clinical response, clinical remission, endoscopic response, endoscopic remission, and adverse events for each combination therapy.
See this image and copyright information in PMC

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