279 Combination Therapy Does Not Improve Clinical and Endoscopic Remission Rates With Vedolizumab or Ustekinumab in Crohn's Disease and Ulcerative Colitis

Hu, Anne; Kotze, Paulo Gustavo; Tan, Wei; Jess, Alison T.; Li, Pei-Shun Mimi; Kroeker, Karen I.; Halloran, Brendan P.; Panaccione, Remo; Ma, Christopher; Ananthakrishnan, Ashwin N.

doi:10.1016/s0016-5085(20)30816-7

Cited by 2 publications

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“…Similar effects have not been seen with adding IMM to UST of VDZ therapy, possibly due to a lower role of immunogenicity in drug metabolism. 92 For patients with perianal CD, a multidisciplinary approach with early referral to a colorectal surgeon is key to improved outcomes. 93 Ileocolic resection as a first-line therapy.…”

Section: Early Therapy For Crohn's Diseasementioning

confidence: 99%

Approach to the Management of Recently Diagnosed Inflammatory Bowel Disease Patients: A User’s Guide for Adult and Pediatric Gastroenterologists

et al. 2021

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Inflammatory bowel diseases (IBDs), including Crohn's disease and ulcerative colitis, are chronic, progressive, immune-mediated diseases of adults and children that have no cure. IBD can cause significant morbidity and lead to complications such as strictures, fistulas, infections, and cancer. In children, IBD can also result in growth impairment and pubertal delays. IBD is highly heterogenous, with severity ranging from mild to severe and symptoms ranging from mild to debilitating. Delay in IBD diagnosis, especially in Crohn's disease, is common and associated with adverse outcomes. Early diagnosis and prompt institution of treatment are the cornerstones for improving outcomes and maximizing health. Early diagnosis requires a low threshold of suspicion and red flags to guide early specialist referral at the primary provider level. Although the armamentarium of IBD medications is growing, many patients will not respond to treatment, and the selection of first-line therapy is critical. Risk stratification of disease severity, based on clinical, demographic, and serologic markers, can help guide selection of first-line therapy. Clinical decision support tools, genomics, and other biomarkers of response to therapy and risk of adverse events are the future of personalized medicine. After starting appropriate therapy, it is important to confirm remission using objective end points (treat to target) with continued control of inflammation with adjustment of therapy using surrogate biomarkers (tight control). Lastly, IBD therapy extends far beyond medications, and other aspects of the overall health and wellbeing of the patient are critical. These include preventive health, nutrition, and psychobehavioral support addressing patients' concerns around complementary therapy and medication adherence, prevention of disability, and ensuring open communication.

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Section: Early Therapy For Crohn's Diseasementioning

confidence: 99%

Approach to the Management of Recently Diagnosed Inflammatory Bowel Disease Patients: A User’s Guide for Adult and Pediatric Gastroenterologists

et al. 2021

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“…In the prospective study mentioned earlier, Hu and colleagues followed 219 patients with CD treated with ustekinumab. After 1 year of follow-up, there was no difference in clinical response, clinical remission, or endoscopic remission when treatment was combined with an immunomodulator compared with when administered as monotherapy 22 Table 1. summarizes these studies.…”

Section: Effect Of Monotherapy Versus Combination Therapy On Clinical...mentioning

confidence: 98%

“…After 1 year of follow-up, there was no difference in clinical response, clinical remission, or endoscopic remission when treatment was combined with an immunomodulator compared with when administered as monotherapy. 22 Table 1 summarizes these studies.…”

Section: Biologic-naive Patients (First Biologic)mentioning

confidence: 99%

First or Second Biologic in Inflammatory Bowel Disease

Aoun

Jabak

Mourad

et al. 2021

Journal of Clinical Gastroenterology

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The therapeutic armamentarium for patients with inflammatory bowel disease has been expanding. Current guidelines make recommendations about whether patients who are biologic naive should be receiving biologic monotherapy or combination therapy, depending on the class of biologics. However, due to the limited available data, guidance to inform clinical practice for patients receiving their second or more biologic are lacking. We hereby review the available data about the use of biologic monotherapy or combination therapy with concomitant immunomodulator therapies in patients receiving their first as well as those receiving their second biologic.

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279 Combination Therapy Does Not Improve Clinical and Endoscopic Remission Rates With Vedolizumab or Ustekinumab in Crohn's Disease and Ulcerative Colitis

Cited by 2 publications

References 0 publications

Approach to the Management of Recently Diagnosed Inflammatory Bowel Disease Patients: A User’s Guide for Adult and Pediatric Gastroenterologists

Approach to the Management of Recently Diagnosed Inflammatory Bowel Disease Patients: A User’s Guide for Adult and Pediatric Gastroenterologists

First or Second Biologic in Inflammatory Bowel Disease

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