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Considerations when starting patients on multiple biologics and small molecules
Sudheer K Vuyyuru1, Saurabh Kedia, Vineet Ahuja
1Department of Gastroenterology and Human nutrition, All India Institute of Medical Sciences, New Delhi, India.
Current Opinion in Gastroenterology
|September 27, 2022
Summary
Combination biologics offer a potential solution to improve outcomes in inflammatory bowel disease (IBD). While appearing safe and effective, further research is needed to confirm benefits for refractory IBD.
Area of Science:
- Immunology
- Gastroenterology
- Pharmacology
Background:
- Inflammatory bowel disease (IBD) presents a significant patient burden, with current therapies plateauing in efficacy.
- Advances in understanding IBD pathophysiology reveal new cytokine targets for treatment.
- Despite new targeted therapies, clinical outcomes for IBD remain a challenge.
Purpose of the Study:
- To review the role and evidence for using multiple biologics in IBD management.
- To discuss considerations for prescribing combination biologic therapies.
- To address the therapeutic ceiling in IBD treatment outcomes.
Main Methods:
- Review of existing evidence on combination biologic therapies for IBD.
- Analysis of safety and efficacy data for current combination approaches.
- Identification of patient subgroups who may benefit from combination biologics.
Main Results:
- Combination biologics show promise in improving IBD clinical outcomes.
- Current evidence suggests combination biologics are safe and effective, but limited.
- Considerations for combination therapy include refractory IBD and extra-intestinal manifestations.
Conclusions:
- Targeting multiple cytokines via combination biologics is a logical strategy for IBD.
- Combination biologics may offer a way to overcome the therapeutic plateau in IBD.
- Well-designed prospective studies are essential to confirm the safety and efficacy of combination biologics in IBD.
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