Combo Therapy Is Safe, Effective in Aggressive IBD

Background: Limited data are available with regard to safety and efficacy of combination therapy for inflammatory bowel disease (IBD). Objective: To comprehensively evaluate the rationale for use of advanced combination therapy, the types of combinations used, and their impact on effectiveness and safety outcomes in patients with IBD. Participants/Methods: Adult patients with IBD receiving 2 biologics, a biologic plus a small molecule, or 2 small molecules were studied retrospectively. Indications for combination therapy included refractory IBD, uncontrolled immune-mediated disease, or uncontrolled extraintestinal manifestations. Results: 105 IBD patients were included. Among them, 39% had perianal involvement, and more than half had failed ≥3 advanced therapies. The most frequent combination regimen was an anti–tumor necrosis factor agent plus an anti-integrin agent. At 12 months, cumulative rates of clinical and endoscopic response were 60.0% and 32.4%, respectively, while more...