Dual Targeted Therapy: a possible option for the management of refractory Inflammatory Bowel Disease

J Crohns Colitis. 2020 Jul 17:jjaa149. doi: 10.1093/ecco-jcc/jjaa149. Online ahead of print.


Background and aims: Dual Targeted Therapy (DTT) has been proposed as a novel therapeutic strategy for the management of complicated patients with Inflammatory Bowel Diseases (IBD). Our aim was to investigate the safety and effectiveness of this approach in a real-life setting.

Methods: We retrospectively extracted data from IBD patients receiving DTT in Italian IBD referral centres. Baseline characteristics, clinical activity of intestinal and extraintestinal disease and C-reactive proteins levels were recorded. All adverse events were reported. Clinical effectiveness, biochemical remission and safety of DTT were investigated.

Results: Sixteen patients were identified; indications for DTT were: "active IBD" or "active EIM" despite ongoing biological therapy. The most commonly used DTT were: vedolizumab + ustekinumab (3 patients) and vedolizumab + adalimumab (3 patients). Clinical response of intestinal or extraintestinal symptoms, according to the indication for DTT, was reported by all patients by the end of the induction. Four patients discontinued DTT during follow-up. Three patients experienced an adverse event; no serious adverse event was reported.

Conclusions: DTT seems to be an effective and safe treatment and may represent an appealing therapeutic strategy for the management of complicated IBD patients.

Keywords: Biologics; Combination Therapy; Extraintestinal manifestations.