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Dual Targeted Therapy for Refractory Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.
Chenyue Xu1,2,3,4, Xueping Huang1,2,3,4, Ye Zong1,2,3,4
1Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Journal of Evidence-Based Medicine
|July 1, 2026
Summary
Dual targeted therapy (DTT) shows promising efficacy for refractory inflammatory bowel disease (IBD), with high response and remission rates. This approach offers an acceptable safety profile, warranting further investigation in large-scale studies.
Area of Science:
- Gastroenterology
- Immunology
- Pharmacology
Background:
- Refractory inflammatory bowel disease (IBD) poses significant challenges in patient management.
- Dual targeted therapy (DTT), utilizing two biologics or small molecules concurrently, is emerging as a potential treatment strategy.
- Evidence suggests DTT may improve outcomes in patients with difficult-to-treat IBD.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy and safety of DTT in refractory IBD.
- To compare the effectiveness of different DTT combination regimens.
- To evaluate clinical response, remission, improvement, and safety outcomes.
Main Methods:
- Systematic literature search across multiple databases (MEDLINE, Embase, Cochrane Library, CBM, CNKI, VIP, WanFang) up to March 8, 2026.
- Inclusion of clinical trials and cohort studies reporting DTT outcomes in IBD patients.
- Assessment of efficacy (clinical response, remission, improvement, endoscopic improvement) and safety (adverse events, serious adverse events).
Main Results:
- Sixty-three studies involving 2097 patients were analyzed.
- Overall DTT demonstrated pooled clinical response (68.0%) and remission (50.7%) rates in refractory IBD.
- Certain combinations, like anti-tumor necrosis factor α (TNFα) plus IL-12/23 inhibitors, showed superior clinical improvement compared to others. Anti-integrin plus IL-12/23 inhibitors exhibited lower adverse event rates than anti-TNFα plus IL-12/23 inhibitors.
Conclusions:
- Dual targeted therapy (DTT) presents promising efficacy and an acceptable safety profile for managing refractory IBD.
- Specific DTT combinations may offer differential benefits in terms of efficacy and safety.
- Further large-scale, high-quality research is necessary to confirm these findings and guide clinical practice.
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