Dual Targeted Therapy: a possible option for the management of refractory Inflammatory Bowel Disease.

Biologics Combination Therapy Extraintestinal manifestations

Journal

Journal of Crohn's & colitis
ISSN: 1876-4479
Titre abrégé: J Crohns Colitis
Pays: England
ID NLM: 101318676

Informations de publication

Date de publication:
17 Jul 2020
Historique:
received: 27 05 2020
entrez: 17 7 2020
pubmed: 17 7 2020
medline: 17 7 2020
Statut: aheadofprint

Résumé

Dual Targeted Therapy (DTT) has been proposed as a novel therapeutic strategy for the management of complicated patients with Inflammatory Bowel Diseases (IBD). Our aim was to investigate the safety and effectiveness of this approach in a real-life setting. We retrospectively extracted data from IBD patients receiving DTT in Italian IBD referral centres. Baseline characteristics, clinical activity of intestinal and extraintestinal disease and C-reactive proteins levels were recorded. All adverse events were reported. Clinical effectiveness, biochemical remission and safety of DTT were investigated. Sixteen patients were identified; indications for DTT were: "active IBD" or "active EIM" despite ongoing biological therapy. The most commonly used DTT were: vedolizumab + ustekinumab (3 patients) and vedolizumab + adalimumab (3 patients). Clinical response of intestinal or extraintestinal symptoms, according to the indication for DTT, was reported by all patients by the end of the induction. Four patients discontinued DTT during follow-up. Three patients experienced an adverse event; no serious adverse event was reported. DTT seems to be an effective and safe treatment and may represent an appealing therapeutic strategy for the management of complicated IBD patients.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Dual Targeted Therapy (DTT) has been proposed as a novel therapeutic strategy for the management of complicated patients with Inflammatory Bowel Diseases (IBD). Our aim was to investigate the safety and effectiveness of this approach in a real-life setting.
METHODS METHODS
We retrospectively extracted data from IBD patients receiving DTT in Italian IBD referral centres. Baseline characteristics, clinical activity of intestinal and extraintestinal disease and C-reactive proteins levels were recorded. All adverse events were reported. Clinical effectiveness, biochemical remission and safety of DTT were investigated.
RESULTS RESULTS
Sixteen patients were identified; indications for DTT were: "active IBD" or "active EIM" despite ongoing biological therapy. The most commonly used DTT were: vedolizumab + ustekinumab (3 patients) and vedolizumab + adalimumab (3 patients). Clinical response of intestinal or extraintestinal symptoms, according to the indication for DTT, was reported by all patients by the end of the induction. Four patients discontinued DTT during follow-up. Three patients experienced an adverse event; no serious adverse event was reported.
CONCLUSIONS CONCLUSIONS
DTT seems to be an effective and safe treatment and may represent an appealing therapeutic strategy for the management of complicated IBD patients.

Identifiants

pubmed: 32674156
pii: 5872608
doi: 10.1093/ecco-jcc/jjaa149
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

Giuseppe Privitera (G)

Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.

Sara Onali (S)

CEMAD - IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

Daniela Pugliese (D)

CEMAD - IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

Sara Renna (S)

IBD Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy.

Edoardo Savarino (E)

Department of Surgery, Oncology and Gastroenterology, Gastroenterology Section, University Hospital of Padua, Padua, Italy.

Anna Viola (A)

Clinical Unit for Chronic Bowel Disorders, Dept. of Clinical and Experimental Medicine, University of Messina.

Davide Giuseppe Ribaldone (DG)

Department of Medical Sciences, University of Turin, Turin, Italy.

Andrea Buda (A)

Department of Gastrointestinal Oncological Surgery, Gastroenterology, Ospedale S. Maria del Prato, Feltre, Italy.

Cristina Bezzio (C)

Gastroenterology Unit, Rho Hospital, Rho (MI), ASST Rhodense, Garbagnate Milanese, Italy.

Gionata Fiorino (G)

IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan 20089, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

Massimo Claudio Fantini (MC)

Gastroenterology Unit, University Hospital of Cagliari, Department of Science and Public Health, University of Cagliari.

Franco Scaldaferri (F)

CEMAD - IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

Luisa Guidi (L)

Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
CEMAD - IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

Silvio Danese (S)

IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan 20089, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

Antonio Gasbarrini (A)

Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
CEMAD - IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

Ambrogio Orlando (A)

IBD Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy.

Alessandro Armuzzi (A)

Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
CEMAD - IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

Classifications MeSH