Abstract
Background: Inflammatory bowel diseases patients eligible for biological therapy represent a group with considerable disease burden and biologics only achieve 40% clinical remission rates in responders after 1 year of therapy. Aims: To collect all the published data about patients treated with dual biological therapy with an Anti-TNF, vedolizumab or ustekinumab, for a period of at least 3 months and to pool the data about the effectiveness and safety. Methods: A MEDLINE, and Web of Science search of all studies published in English until 1 January 2019 was conducted. Results: We included 7 studies with a total of 18 patients. Fifteen patients were treated with a combination of an anti-TNF and vedolizumab, 3 patients were treated with vedolizumab and ustekinumab. Fifty-six percent of patients were affected by Crohn’s disease and 50% of patients were treated with an immunosuppressant drug or steroid too. A clinical improvement was obtained in 100% of patients, and an endoscopic improvement in 93% of patients. No serious adverse events were reported. Conclusions: The use of dual biological therapy is an attractive therapeutic option and may be an opportunity to better tailor and personalize the therapies for patients. Further studies, as randomized control trials, to provide comparative efficacy and safety endpoints of combination therapies, and to clarify potential advantages of combined biological therapies, are needed.
| Original language | English |
|---|---|
| Pages (from-to) | 407-413 |
| Number of pages | 7 |
| Journal | Scandinavian Journal of Gastroenterology |
| Volume | 54 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 3 2019 |
| Externally published | Yes |
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Keywords
- Anti-integrin
- biologics
- Crohn’s disease
- inflammatory bowel disease
- ulcerative colitis
ASJC Scopus subject areas
- Gastroenterology
Cite this
Dual biological therapy with anti-TNF, vedolizumab or ustekinumab in inflammatory bowel disease : a systematic review with pool analysis. / Ribaldone, Davide Giuseppe; Pellicano, Rinaldo; Vernero, Marta; Caviglia, Gian Paolo; Saracco, Giorgio Maria; Morino, Mario; Astegiano, Marco.
In: Scandinavian Journal of Gastroenterology, Vol. 54, No. 4, 03.04.2019, p. 407-413.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Dual biological therapy with anti-TNF, vedolizumab or ustekinumab in inflammatory bowel disease
T2 - a systematic review with pool analysis
AU - Ribaldone, Davide Giuseppe
AU - Pellicano, Rinaldo
AU - Vernero, Marta
AU - Caviglia, Gian Paolo
AU - Saracco, Giorgio Maria
AU - Morino, Mario
AU - Astegiano, Marco
PY - 2019/4/3
Y1 - 2019/4/3
N2 - Background: Inflammatory bowel diseases patients eligible for biological therapy represent a group with considerable disease burden and biologics only achieve 40% clinical remission rates in responders after 1 year of therapy. Aims: To collect all the published data about patients treated with dual biological therapy with an Anti-TNF, vedolizumab or ustekinumab, for a period of at least 3 months and to pool the data about the effectiveness and safety. Methods: A MEDLINE, and Web of Science search of all studies published in English until 1 January 2019 was conducted. Results: We included 7 studies with a total of 18 patients. Fifteen patients were treated with a combination of an anti-TNF and vedolizumab, 3 patients were treated with vedolizumab and ustekinumab. Fifty-six percent of patients were affected by Crohn’s disease and 50% of patients were treated with an immunosuppressant drug or steroid too. A clinical improvement was obtained in 100% of patients, and an endoscopic improvement in 93% of patients. No serious adverse events were reported. Conclusions: The use of dual biological therapy is an attractive therapeutic option and may be an opportunity to better tailor and personalize the therapies for patients. Further studies, as randomized control trials, to provide comparative efficacy and safety endpoints of combination therapies, and to clarify potential advantages of combined biological therapies, are needed.
AB - Background: Inflammatory bowel diseases patients eligible for biological therapy represent a group with considerable disease burden and biologics only achieve 40% clinical remission rates in responders after 1 year of therapy. Aims: To collect all the published data about patients treated with dual biological therapy with an Anti-TNF, vedolizumab or ustekinumab, for a period of at least 3 months and to pool the data about the effectiveness and safety. Methods: A MEDLINE, and Web of Science search of all studies published in English until 1 January 2019 was conducted. Results: We included 7 studies with a total of 18 patients. Fifteen patients were treated with a combination of an anti-TNF and vedolizumab, 3 patients were treated with vedolizumab and ustekinumab. Fifty-six percent of patients were affected by Crohn’s disease and 50% of patients were treated with an immunosuppressant drug or steroid too. A clinical improvement was obtained in 100% of patients, and an endoscopic improvement in 93% of patients. No serious adverse events were reported. Conclusions: The use of dual biological therapy is an attractive therapeutic option and may be an opportunity to better tailor and personalize the therapies for patients. Further studies, as randomized control trials, to provide comparative efficacy and safety endpoints of combination therapies, and to clarify potential advantages of combined biological therapies, are needed.
KW - Anti-integrin
KW - biologics
KW - Crohn’s disease
KW - inflammatory bowel disease
KW - ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=85066872334&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85066872334&partnerID=8YFLogxK
U2 - 10.1080/00365521.2019.1597159
DO - 10.1080/00365521.2019.1597159
M3 - Review article
VL - 54
SP - 407
EP - 413
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
SN - 0036-5521
IS - 4
ER -