Efficacy and safety of dual-targeted therapy for inflammatory bowel disease: a retrospective multicenter study in China

Therapeutic Advances in Gastroenterology, Journal Year: 2025, Volume and Issue: 18

Published: Jan. 1, 2025

Background: Treatment options for patients with refractory inflammatory bowel disease (IBD) or concomitant IBD and extraintestinal manifestations (EIM) are often limited. Objective: This study aimed to examine the efficacy safety of combining biologics small molecules in IBD, active EIM, immune-mediated (IMID). Design: was a retrospective multicenter study. Methods: We retrospectively collected demographics characteristics from 47 who received dual-targeted therapy 3 hospitals January 2022 June 2024. The primary endpoint clinical remission based on Harvey–Bradshaw index patient-reported outcome 2 after at least 4 months combination therapy. secondary endpoints included response, endoscopic remission, as well all adverse events that occurred within period Results: In total, including 37 5 IMID therapy, which achieved response (78.7%) 27 (57.4%) median follow-up time 13.0 months. Among these patients, 29 underwent follow-up, 15 (51.7%) 8 (27.6%) 9.0 Mild moderate were reported 17 (36.2%) serious requiring hospitalization 1 patient (2.1%). Conclusion: those EIM/IMID is effective safe.

Language: Английский

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Review article: Novel therapies in inflammatory bowel disease – An update for clinicians

Alimentary Pharmacology & Therapeutics, Journal Year: 2024, Volume and Issue: 60(9), P. 1244 - 1260

Published: Oct. 15, 2024

Several new treatments including small molecules and biologics have been approved for the treatment of inflammatory bowel diseases in recent years. Clinicians patients now a wide variety therapeutic options to choose from these novel therapies provide several advantages oral administration, lower immunogenicity, better selectivity arguably safety profiles. An increase has increased complexity decision-making. Both clinicians had become rapidly familiar with efficacy medications balanced against range pre-initiation requirements, dosing schedules adverse event

Language: Английский

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Comprehensive care of ulcerative colitis: new treatment strategies

Expert Review of Gastroenterology & Hepatology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 26, 2025

Ulcerative colitis is a chronic inflammatory condition of the colon driven by aberrant immune activation. Although advanced medical therapies form cornerstone ulcerative management, unmet needs include failure to induce and sustain remission in substantial proportion patients managing acute severe colitis. We review new treatment strategies that might improve patient outcomes management moderate-to-severe A literature search was conducted using PubMed database, including studies published from inception October 2024, selected for their relevance. Recognizing current limitations, this article reviews therapies. These approaches early initiation, dose optimization, positioning newer agents as first-line therapies, combination therapy, targeting novel therapeutic endpoints, The discussed may contribute establishing standards care aimed at achieving long-term enhancing outcomes. Personalized which tailors based on individual disease characteristics risk factors, anticipated become critical aspect delivering more effective future.

Language: Английский

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Comparative Effectiveness of Dual Biologic Therapy and Biologic Small‐Molecule Therapy for Refractory Inflammatory Bowel Disease: A Retrospective Single‐Center Study

Clinical and Translational Science, Journal Year: 2025, Volume and Issue: 18(3)

Published: March 1, 2025

ABSTRACT Patients with refractory inflammatory bowel disease (IBD) face difficulty in the treatment strategy. Combined advanced targeted therapies may obtain higher therapeutic efficacy. However, few studies compare efficacy and safety of dual biologic therapy (DBT) small‐molecule (BMT) for IBD. We aimed to effectiveness DBT BMT. retrospectively analyzed data patients IBD treated ( n = 22) or BMT 21). The primary outcome was clinical remission rate at week 12. Secondary outcomes included response rate, endoscopic colectomy adverse events (AEs) At 12, rates group were 22.7% 28.6%, respectively. No statistically significant difference observed between two groups p 0.661). There also no differences (68.2% vs. 71.4%, 0.817), (66.7% 68.8%, 1.000), (4.8% 18.8%, 0.296) (4.5% 23.8%, 0.167). Two (9.5%) experienced AEs. not 0.233). In conclusion, this study revealed that there be similar Further multi‐center, prospective randomized controlled trials are necessary confirm conclusion.

Language: Английский

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Combining Advanced Targeted Therapy in Inflammatory Bowel Disease: Current Practice and Future Directions

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(2), P. 590 - 590

Published: Jan. 17, 2025

Background/Objectives: Despite the increasing number of available medications, a significant proportion IBD patients fail to achieve current therapeutic targets. Uncontrolled has impact on patients' quality life and overall costs for healthcare system. Given complex pathophysiology IBD, Combined Advanced Targeted Therapy (CATT), involving combination biologics/small molecules, appears have biological plausibility is gaining interest. The aim this narrative review provide evidence regarding CATT in propose future developments field. Methods: Relevant literature was searched with pertinent MeSH terms most important database. Results: Available provides encouraging results efficacy effectiveness, an acceptable safety profile. may represent solution "difficult-to-treat" or concomitant immune-mediated inflammatory diseases. However, data are restricted by low level short follow-up. Conclusions: There no concluding superiority one therapy over another. Various schemes could be applied near future. Further studies needed recommendations integrate strategy into everyday clinical practice.

Language: Английский

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Dual Therapy in Inflammatory Bowel Disease

Biomolecules, Journal Year: 2025, Volume and Issue: 15(2), P. 222 - 222

Published: Feb. 3, 2025

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

Language: Английский

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A practical approach to positioning therapies in ulcerative colitis

Journal of the Canadian Association of Gastroenterology, Journal Year: 2025, Volume and Issue: 8(Supplement_2), P. S6 - S14

Published: Feb. 21, 2025

Abstract The therapeutic landscape of ulcerative colitis (UC) has undergone significant change over the last 2 decades. While there are multiple new therapies for management UC, long-term remission rates remain low, and this may be in part due to difficulty navigating a successful treatment strategy. In review, we propose rational framework selection, sequencing, optimization patients with UC. We outline goals targets followed by discussion challenges selection considerations help guide sequencing These include an assessment therapy’s efficacy safety, convenience delivery therapy, ease access, patient-related factors. then provide overview currently approved in-depth analysis their advantages disadvantages. Finally, conclude future directions which use naturopathic therapies, faecal microbiota precision medicine, other strategies such as combination therapy.

Language: Английский

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Advanced Combination Therapy with Biologics and Upadacitinib in Refractory Inflammatory Bowel Disease: A Retrospective Study from Taiwan

Journal of Inflammation Research, Journal Year: 2025, Volume and Issue: Volume 18, P. 2733 - 2742

Published: Feb. 1, 2025

Refractory inflammatory bowel disease (IBD) remains challenging despite the availability of various biologics. Advanced combination therapy (ACT) with biologics and Upadacitinib (UPA), a rapid-onset oral selective Janus kinase inhibitor, has shown promise in managing refractory IBD. However, its use Asia not been explored. This study aims to fill that gap by providing data from Taiwan. retrospective included IBD patients who received ACT UPA, followed up at Chang Gung Inflammatory Bowel Disease Center July 2020 August 2024. Patients were assessed for clinical response remission weeks 4, 12, 24. Safety profiles monitored throughout follow-up period evaluate risk adverse events. Sixteen enrolled. The median duration was 4.5 years [IQR 2.25-9.50]. most common regimen Ustekinumab plus UPA (63%). Clinical rates 24 88%, 83%, 100%, respectively, while 31%, 50%, 80%. One patient (6.25%) experienced minor event (acne), no major events like herpes zoster reactivation or cardiac complications. is first demonstrate UPA-based both effective safe treating limitations this retrospective, single-center relatively small sample size highlight need future larger-scale, multi-center prospective studies confirm these findings, identify predictors treatment response, long-term outcomes.

Language: Английский

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Who and how to choose combination therapy for inflammatory bowel disease: a comprehensive expert review

Current Opinion in Gastroenterology, Journal Year: 2025, Volume and Issue: unknown

Published: April 4, 2025

Purpose of review Therapeutic options in inflammatory bowel disease (IBD) have expanded significantly. Patients often experience primary or secondary loss response to biologics small molecules therapy. Determining which patients may benefit from combination two therapies remains a key question. Recent findings Combination therapy leverages complementary mechanisms action, conventionally using tumor necrosis factor antagonists simultaneously with immunosuppressive agents, and more recently advanced together. has shown promise recent randomized trials for improving clinical endoscopic outcomes while maintaining acceptable safety profiles. Observational studies highlight its potential refractory complex phenotypes. Guidelines still conservatively recommend monotherapy IBD patients, even those at high risk complications. Summary Advanced (ACT) represents significant advancement managing IBD, offering treatment cases, concomitant immune-mediated diseases high-risk populations. Nonetheless, further registry data are needed generate evidence support broader adoption this approach. Future research should focus on cost-effectiveness, longer-term strategies refine application practice.

Language: Английский

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Mirikizumab for Ulcerative Colitis: A Game-Changer or Just Another Incremental Advance?

Digestive Diseases and Sciences, Journal Year: 2025, Volume and Issue: unknown

Published: April 16, 2025

Language: Английский

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