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Review
. 2025 Feb 3;15(2):222.
doi: 10.3390/biom15020222.

Dual Therapy in Inflammatory Bowel Disease

Gabriele Altieri  1   2 , Alessandra Zilli  1 , Tommaso Lorenzo Parigi  2 , Mariangela Allocca  1 , Federica Furfaro  1 , Gionata Fiorino  3 , Clelia Cicerone  1 , Laurent Peyrin-Biroulet  4 , Silvio Danese  1   2 , Ferdinando D'Amico  1
Affiliations
Review

Dual Therapy in Inflammatory Bowel Disease

Gabriele Altieri et al. Biomolecules. .

Abstract

Inflammatory bowel diseases (IBDs), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic and complex autoimmune conditions. Despite the advancements in biologics and small molecules, the therapeutic ceiling persists, posing significant treatment challenges and contributing to the concept of difficult-to-treat IBD. Dual-targeted therapy (DTT), combining two biologic agents or biologics with small molecules, has emerged as a novel approach to address this unmet need by targeting multiple inflammatory pathways simultaneously. Evidence suggests that DTT holds promise in improving clinical and endoscopic outcomes, especially in patients with refractory disease or extraintestinal manifestations. Safety data, while consistent with monotherapy profiles, highlight the importance of vigilant monitoring for infections and other adverse events. Continued research and high-quality trials are crucial to defining optimal DTT regimens and broadening its clinical applicability. This review explores the efficacy and safety of DTT in IBD, reporting data from clinical trials, systematic reviews, and real-world studies.

Keywords: Crohn’s disease; combination therapy; dual-targeted therapy; inflammatory bowel disease; ulcerative colitis.

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Conflict of interest statement

F.D. has served as a speaker for Abbvie, Takeda, Tillotts, Ferring, Sandoz, Janssen, Galapagos, and Omega Pharma; he also served as an advisory board member for Abbvie, Ferring, Galapagos, Nestlè, and Takeda. M.A. has received consulting fees from Nikkiso Europe, Mundipharma, Janssen, AbbVie, Ferring, and Pfizer. F.F. received consulting fees from Amgen, AbbVie, Lilly, Janssen, and Pfizer. S.D. has served as a speaker, consultant, and advisory board member for Scher-ing-Plough, AbbVie, Actelion, Alphawasserman, AstraZeneca, Cellerix, Cosmo Pharmaceuticals, Ferring, Genentech, Grunenthal, Johnson and Johnson, Millenium Takeda, MSD, Nikkiso Europe GmbH, Novo Nordisk, Nycomed, Pfizer, Pharmacosmos, UCB Pharma, and Vifor. G.F. received consultancy fees from Ferring, MSD, AbbVie, Takeda, Janssen, Amgen, Sandoz, Samsung Bioepis, and Celltrion. L.P.-B. declares personal fees from Galapagos, AbbVie, Janssen, Genentech, Ferring, Tillots, Celltrion, Takeda, Pfizer, Index Pharmaceuticals, Sandoz, Celgene, Biogen, Samsung Bioepis, Inotrem, Allergan, MSD, Roche, Arena, Gilead, Amgen, BMS, Vifor, Norgine, Mylan, Lilly, Fresenius Kabi, OSE Immunotherapeutics, Enthera, Theravance, Pandion Therapeutics, Gossamer Bio, Viatris, and Thermo Fisher; grants from Abbvie, MSD, Takeda, and Fresenius Kabi; and stock options from CTMA. The other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Key benefits of DTT in overcoming the therapeutic ceiling in IBD.
See this image and copyright information in PMC

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