Efficacy of Combination Vedolizumab and Ustekinumab for Refractory Crohnʼs Disease

Huff-Hardy, Kayci; Bedair, Mai; Vazquez, Rebecca; Burstein, Ezra

doi:10.1097/mib.0000000000001232

Cited by 20 publications

(7 citation statements)

References 5 publications

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“…It seems that this combination of biological drugs (VDZ + UST) may be particularly useful in the treatment of patients with fistulas, leading to the closure of a fistula and obtaining continuity after the takedown of a stoma. These reports are also confirmed by publications in the adult population of patients suffering from inflammatory bowel diseases [ 19 , 20 , 21 ]. The authors emphasize that they decided to use such a combination of two biological drugs because of a better safety profile than in the case of using anti-TNF drugs.…”

Section: Discussionsupporting

confidence: 73%

“…The treatments with combinations of biological medications seems to be a safe and well-tolerated option for pediatric IBD. In the first retrospective study [ 20 ], nine patients with CD were included, and one patient had a staphylococcal skin infection during dual biological therapy. In 2021, Dolinger published a study that reported the occurrence of one serious adverse event of septic arthritis after two months of treatment with vedolizumab and tofacitinib [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Dual Biologic Therapy for the Treatment of Pediatric Inflammatory Bowel Disease: A Review of the Literature

Wlazło

Kierkuś

2022

JCM

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Background: pediatric patients with inflammatory bowel diseases (IBD) who qualify for biological therapy represent a group of severely ill patients. They have never been successful with conventional medication. Biologic medications in monotherapy are frequently used in the disease course, however they result in a 1-year remission, which can be maintained in approximately 40% of IBD patients. Method: the present study aims to summarize the review of literature data on the use of therapy with a combination of two biological and small molecule drugs, anti-TNF (infliximab, adalimumab), vedolizumab and ustekinumab, as well as Janus kinase inhibitors (tofacitinib). The risks associated with the use of dual biological therapy and potential adverse effects are particularly important. The literature data was reviewed using the following terms: “use of combination biologic in paediatric IBD”, “combination biologics”, and “dual biologic for treatment of Inflammatory Bowel Disease”. Conclusion: the use of dual biological therapy is a new therapeutic option. In pediatric IBD, combining the different mechanisms of action of the two biological drugs seems to be safe and effective. Anti-TNF drugs with vedolizumab or ustekinumab may be a particularly beneficial combination. Nevertheless, the clarification and justification of potential advantages of combined biological therapies in further studies, such as randomized control trials, are needed.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Dual Biologic Therapy for the Treatment of Pediatric Inflammatory Bowel Disease: A Review of the Literature

Wlazło

Kierkuś

2022

JCM

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“…Similarly, new combinations of therapy may offer novel approaches. Case reports of patients with unremitting perianal disease have demonstrated significant response to dual biologic therapy [88]. It will be interesting to note whether, and how we might pursue investigating the effect of dual biologic therapy on outcomes.…”

Section: Expert Opinionmentioning

confidence: 99%

Recent advances in the management of perianal fistulizing Crohn’s disease: lessons for the clinic

Lopez

Ramamoorthy

Sandborn

2019

Expert Review of Gastroenterology & Hepatology

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Introduction:Managing fistulizing perianal disease is among the most challenging aspects of treating patients with Crohn's disease. Perianal fistulas are indicative of poor long-term prognosis. They are commonly associated with significant morbidities and can have detrimental effects on quality of life. While durable fistula closure is ideal, it is uncommon.In optimal circumstances, reported long-term fistula healing rates are only slightly higher than 50% and recurrence is common. Achieving these results requires a combined medical and surgical approach, highlighting the importance of a highly skilled and collaborative multi-disciplinary team.In recent years, advances in imaging, biologic therapies and surgical techniques have lent to growing enthusiasm amongst treatment teams, however the most advantageous approach is yet to be determined. Areas covered:Here we review current management approaches, incorporating recent guidelines and novel therapies. Additionally, we discuss recently published and ongoing studies that will likely impact practice in the coming years.Expert opinion: Investing in concerted collaborative multi-institutional efforts will be necessary to better define optimal timing and dosing of medical therapy, as well as to identify ideal timing

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“…The use of ustekinumab in combination with another biologics (anti‐TNF agent or vedolizumab) in refractory CD has been described with favorable outcomes . Evidence to date is, however, very limited, particularly for long‐term safety.…”

Section: Ustekinumabmentioning

confidence: 99%

A review of vedolizumab and ustekinumab for the treatment of inflammatory bowel diseases

et al. 2018

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Recent advancement in the understanding of the pathophysiology of inflammatory bowel disease has seen an expansion in therapeutic options. Vedolizumab, a selective α4β7 inhibitor, and ustekinumab, an IL 12/23 p40 inhibitor, have provided the much‐awaited out‐of‐class alternatives for patients who have failed or who are intolerant to anti‐Tumor Necrosis Factor (TNF) therapy. However, questions remain as to how we may best use these novel therapeutic agents. We evaluate the evidence available from randomized controlled trials and postmarketing cohort studies and discuss their safety, efficacy, and limitations, in relation to anti‐TNF therapy, in optimizing the treatment outcomes.

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Efficacy of Combination Vedolizumab and Ustekinumab for Refractory Crohnʼs Disease

Cited by 20 publications

References 5 publications

Dual Biologic Therapy for the Treatment of Pediatric Inflammatory Bowel Disease: A Review of the Literature

Dual Biologic Therapy for the Treatment of Pediatric Inflammatory Bowel Disease: A Review of the Literature

Recent advances in the management of perianal fistulizing Crohn’s disease: lessons for the clinic

A review of vedolizumab and ustekinumab for the treatment of inflammatory bowel diseases

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