Abstract

A practical guide to combination advanced therapy in inflammatory bowel disease

Curr Opin Gastroenterol. 2024 Jul 1;40(4):251257.doi:10.1097/MOG.0000000000001033. Epub 2024 Apr 16.

 

Christina M Ray 1Remo Panaccione 2Christopher Ma 2 3

 
     

Author information

1Department of Medicine.

2Division of Gastroenterology & Hepatology, Department of Medicine.

3Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Abstract

Purpose of review: To provide an overview of the current literature regarding the use of advanced combination therapy (ACT) in patients with inflammatory bowel disease (IBD). Although the treatment of IBD has come a long way, many patients do not respond or will lose response to currently available treatments over time. ACT has been proposed as a model to create sustained remission in difficult-to-treat IBD patient populations. This review discusses the available literature supporting the use of ACT, followed by practical tips for applying this model of treatment to clinical practice.

Recent findings: Both observational and controlled evidence have demonstrated that there may be an increased benefit of ACT in specific IBD patient populations compared to advanced targeted immunomodulator (TIM) monotherapy. Additional data is required to understand how to best use combination TIMs and the long-term risks associated with this strategy.

Summary: While the literature has demonstrated the potential for benefit in both Crohn's disease and ulcerative colitis, the use of ACT is currently off-label and long-term controlled data is needed. The successful application of ACT requires careful consideration of both patient and disease profiles as well as close monitoring of treatment response and adverse events.

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