Dual biologic therapy in patient with refractory ulcerative colitis and comorbidities: A case report

Despite advances in the treatment of ulcerative colitis (UC), some patients remain refractory to the currently available treatments. Dual biologic therapy (DBT) has emerged as a promising strategy for these patients.

A patient with extensive UC presented with steroid dependence and contraindications (past medical history included breast cancer and previous myocardial infarction) to treatment with tumor necrosis factor and Janus kinase inhibitors. DBT of α4β7 integrin antagonist (vedolizumab) and interleukin 23p19 inhibitor (mirikizumab) resulted in a sustained clinical and biochemical remission. No adverse events were recorded during the follow-up.

This case highlighted the challenge of managing refractory UC, especially in frail patients.