Current Evidence for Combined Targeted Therapy for the Treatment of Inflammatory Bowel Disease

被引:9
|
作者
Wetwittayakhlang, Panu [1 ,2 ]
Lakatos, Peter L. [1 ,3 ]
机构
[1] McGill Univ, Div Gastroenterol & Hepatol, Hlth Ctr, 1650 Cedar Ave, Montreal, PQ H3G 1A4, Canada
[2] Prince Songkla Univ, Fac Med, Div Internal Med, Gastroenterol & Hepatol Unit, 15 Karnjanavanich Rd, Hat Yai 90110, Songkhla, Thailand
[3] Semmelweis Univ, Dept Oncol & Med, 1083, Korany Sandor u 2-a, H-1085 Budapest, Hungary
关键词
inflammatory bowel disease; combination therapy; biologic; combined targeted therapy; CROHNS-DISEASE; COMBINATION; SAFETY; EFFICACY; VEDOLIZUMAB; BIOLOGICS; REMISSION;
D O I
10.1093/jcag/gwad032
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Biologicals and small molecules have revolutionized the medical management of inflammatory bowel diseases (IBD), yet they are only effective in a proportion of patients, and their impact on changing the natural history of the disease is still debatable. Recently, the concept of combining targeted biologics and small-molecule therapies has been introduced to the treatment of IBD. Dual-targeted therapy (sequential and combined), which is the combination of two targeted therapies, might be a reasonable choice for patients to break through the therapeutic ceiling. A recent randomized clinical trial (VEGA) provided the first controlled evidence that the short-term combination of two biological agents may lead to superior disease control than either of the agents alone in patients with ulcerative colitis (UC) without jeopardizing safety. Multiple studies are underway in both Crohn's disease and UC. Additionally, real-world evidence is accumulating in IBD patients receiving combination therapies with concomitant IBD and extraintestinal manifestations or in patients with medically refractory IBD. Of note, the majority of these patients were exposed to multiple biological agents earlier and lost response to at least one of the agents in the combination. This review summarizes current knowledge regarding this attractive novel therapeutic option in IBD. Clearly, more controlled data are needed to evaluate optimal timing, efficacy, and mitigation of safety concerns.
引用
收藏
页码:22 / 29
页数:8
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