Combination therapy of Crohn's disease with an interleukin 12/23 inhibitor and a targeted immunosuppressant: Clinical cases

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Abstract

Several clinical studies, reviews, and clinical observations of dual biological therapy—the simultaneous use of two genetically engineered biological
drugs and/or targeted immunosuppressants in Crohn's disease (CD)—have been published in recent years. The article presents clinical cases with
dual biological therapy with upadacitinib and ustekinumab in patients with severe CD, which was preceded by genetically engineered biological
therapy. After 26 weeks of combination therapy, all patients achieved clinical, endoscopic, and immunobiological remission of CD without serious
adverse events.

About the authors

Oleg V. Knyazev

Loginov Moscow Clinical Scientific Center

Author for correspondence.
Email: o.knyazev@mknc.ru
ORCID iD: 0000-0001-7250-0977
SPIN-code: 3268-0360

D. Sci. (Med.), Loginov Moscow Clinical Scientific Center

Russian Federation, Moscow

Anna V. Kagramanova

Loginov Moscow Clinical Scientific Center; Research Institute for Healthcare Organization and Medical Management

Email: o.knyazev@mknc.ru
ORCID iD: 0000-0002-3818-6205
SPIN-code: 4086-6745

Cand. Sci. (Med.), Loginov Moscow Clinical Scientific Center, Research Institute for Healthcare Organization and Medical Management

Russian Federation, Moscow; Moscow

Albina A. Lishchinskaia

Loginov Moscow Clinical Scientific Center

Email: o.knyazev@mknc.ru
ORCID iD: 0000-0001-7891-2702
SPIN-code: 9369-9674

Cand. Sci. (Med.), Loginov Moscow Clinical Scientific Center

Russian Federation, Moscow

Elena A. Sabelnikova

Loginov Moscow Clinical Scientific Center; Russian University of Medicine

Email: o.knyazev@mknc.ru
ORCID iD: 0000-0001-7519-2041
SPIN-code: 5387-7552

D. Sci. (Med.)

Russian Federation, Moscow; Moscow

Natalia V. Lazuka

Loginov Moscow Clinical Scientific Center

Email: o.knyazev@mknc.ru
ORCID iD: 0009-0006-3851-3305
SPIN-code: 6112-0291

Res. Assist.

Russian Federation, Moscow

Asfold I. Parfenov

Loginov Moscow Clinical Scientific Center

Email: o.knyazev@mknc.ru
ORCID iD: 0000-0002-9782-4860

D. Sci. (Med.), Prof.

Russian Federation, Moscow

References

  1. Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology. 2021;160(5):1570-53. doi: 10.1053/j.gastro.2020.12.031
  2. Haider M, Lashner B. Dual Targeted Therapy for the Management of Inflammatory Bowel Disease. J Clin Gastroenterol. 2021;55(8):661-6. doi: 10.1097/MCG.0000000000001583
  3. Ahmed W, Galati J, Kumar A, et al. Dual Biologic or Small Molecule Therapy for Treatment of Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2022;20(3):e361-39. doi: 10.1016/j.cgh.2021.03.034
  4. Balderramo D. Role of the combination of biologics and/or small molecules in the treatment of patients with inflammatory bowel disease. World J Gastroenterol. 2022;28(47):6743-71. doi: 10.3748/wjg.v28.i47.6743
  5. Mas EB, Calvo XC. Selecting the Best Combined Biological Therapy for Refractory Inflammatory Bowel Disease Patients. J Clin Med. 2022;11(4):1076. doi: 10.3390/jcm11041076
  6. Privitera G, Onali S, Pugliese D, et al. Dual Targeted Therapy: a possible option for the management of refractory Inflammatory Bowel Disease. J Crohns Colitis. 2020;jjaa149. doi: 10.1093/ecco-jcc/jjaa149
  7. Glassner K, Oglat A, Duran A, et al. The use of combination biological or small molecule therapy in inflammatory bowel disease: A retrospective cohort study. J Dig Dis. 2020;21(5):264-71. doi: 10.1111/1751-2980.12867
  8. Kwapisz L, Raffals LE, Bruining DH, et al. Combination Biologic Therapy in Inflammatory Bowel Disease: Experience From a Tertiary Care Center. Clin Gastroenterol Hepatol. 2021;19(3):616-1. doi: 10.1016/j.cgh.2020.02.017
  9. Sands BE, Kozarek R, Spainhour J, et al. Safety and tolerability of concurrent natalizumab treatment for patients with Crohn's disease not in remission while receiving infliximab. Inflamm Bowel Dis. 2007;13(1):2-11. doi: 10.1002/ibd.20014
  10. Yang E, Panaccione N, Whitmire N, et al. Efficacy and safety of simultaneous treatment with two biologic medications in refractory Crohn's disease. Aliment Pharmacol Ther. 2020;51(11):1031-8. doi: 10.1111/apt.15719
  11. Honap S, Netter P, Danese S, Peyrin-Biroulet L. An update on the safety of long-term vedolizumab use in inflammatory bowel disease. Expert Opin Drug Saf. 2023;22(9):767-76. doi: 10.1080/14740338.2023.2247976
  12. Avedillo-Salas A, Corral-Cativiela S, Fanlo-Villacampa A, Vicente-Romero J. The Efficacy and Safety of Biologic Drugs in the Treatment of Moderate-Severe Crohn's Disease: A Systematic Review. Pharmaceuticals (Basel). 2023;16(11):1581. doi: 10.3390/ph16111581
  13. Miyatani Y, Choi D, Choi NK, Rubin DT. Dual-Targeted Therapy with Upadacitinib and Ustekinumab in Medically Complex Crohn's Disease. Dig Dis Sci. 2024;69(2):355-5. doi: 10.1007/s10620-023-08182-y
  14. Harvey Bradshaw Index for Crohn’s disease calculator. Available at: https://www.thecalculator.co/health/Harvey-Bradshaw-Index-For-Crohn%E2%80%99s-Disease-Calculator-1036.html. Accessed: 25.04.2025.
  15. Daperno M, D'Haens G, Van Assche G, et al. Development and validation of a new, simplified endoscopic activity score for Crohn's disease: the SES-CD. Gastrointest Endosc. 2004;60(4):505-12. doi: 10.1016/s0016-5107(04)01878-4

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Imagen endoscópica del íleon terminal del paciente 1. SES-CD – 0 puntos.

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