Efficacy and Safety of Dual Targeted Therapy for Partially or Non-responsive Inflammatory Bowel Disease: A Systematic Review of the Literature.
Publication/Presentation Date
2-20-2023
Abstract
BACKGROUND: Dual targeted therapy (DTT) has emerged as an attractive therapeutic option for select patients with active inflammatory bowel disease (IBD) who are unable to achieve remission with biologic or small molecule monotherapy. We conducted a systematic review of specific DTT combinations in patients with IBD.
METHODS: We conducted a systematic search of MEDLINE, EMBASE, Scopus, CINAHL Complete, Web of Science Core Collection, and Cochrane Library to identify articles related to the use of DTT for the treatment of Crohn Disease (CD) or ulcerative colitis (UC) published before February 2021.
RESULTS: Twenty-nine studies were identified comprising 288 patients started on DTT for partially or non-responsive IBD. We identified 14 studies with 113 patients receiving anti-tumor necrosis factor (TNF) and anti-integrin therapies (i.e., vedolizumab and natalizumab), 12 studies with 55 patients receiving vedolizumab and ustekinumab, nine studies with 68 patients receiving vedolizumab and tofacitinib, five studies with 24 patients receiving anti-TNF therapy and tofacitinib, six studies with 18 patients receiving anti-TNF therapy and ustekinumab, and three studies with 13 patients receiving ustekinumab and tofacitinib.
CONCLUSION: DTT is a promising approach to improve IBD treatment for patients with incomplete responses to targeted monotherapy. Larger prospective clinical studies are needed to confirm these findings as is additional predictive modeling to identify the patient subgroups most likely to require and benefit from this approach.
First Page
1
Last Page
20
ISSN
1573-2568
Published In/Presented At
Berinstein, E. M., Sheehan, J. L., Jacob, J., Steiner, C. A., Stidham, R. W., Shannon, C., Bishu, S., Levine, J., Cohen-Mekelburg, S. A., Waljee, A. K., Higgins, P. D. R., & Berinstein, J. A. (2023). Efficacy and Safety of Dual Targeted Therapy for Partially or Non-responsive Inflammatory Bowel Disease: A Systematic Review of the Literature. Digestive diseases and sciences, 1–20. Advance online publication. https://doi.org/10.1007/s10620-023-07837-0
Disciplines
Medicine and Health Sciences
PubMedID
36807832
Department(s)
Department of Medicine, Department of Medicine Fellows and Residents, Fellows and Residents
Document Type
Article