Department of Gastroenterology, Oslo University Hospital.
Faculty of Medicine, University of Oslo.
Inflamm Bowel Dis. 2018 Apr 23;24(5):997-1004. doi: 10.1093/ibd/izx110.
Anti-tumor necrosis factor α (anti-TNF-α) is important in the treatment of inflammatory bowel disease, but some patients experience only a partial response. In these patients, a combination of anti-TNF-α and vedolizumab (VDZ) may act as a bridge until the full VDZ effect occurs. At present, clinical data on combination treatment with anti-TNF-α and VDZ are not available. The aim of this case series was to evaluate the safety and clinical response of combination therapy with anti-TNF-α and VDZ in clinical practice.
All patients started on combination treatment with anti-TNF-α and VDZ from November 2015 to July 2016 were prospectively followed for at least 12 months.
Six patients with ulcerative colitis and four patients with Crohn's disease received combination treatment. These patients were followed for a median of 1712-20 months. No more adverse events than expected with anti-TNF-α alone were observed during combination treatment. At the end of follow-up, all patients were in clinical remission, and 8 patients could discontinue anti-TNF-α treatment and receive VDZ monotherapy. Two of the patients with Crohn's disease required combination treatment throughout follow-up to obtain sustained remission.
Our findings suggest that combination treatment with anti TNF-α and VDZ is safe and might represent a long-term treatment option in selected patients.
抗肿瘤坏死因子 α（anti-TNF-α）在治疗炎症性肠病中很重要，但有些患者仅出现部分缓解。在这些患者中，anti-TNF-α 与 vedolizumab（VDZ）联合治疗可能是一种桥梁，直到 VDZ 发挥完全作用。目前，尚无关于 anti-TNF-α 与 VDZ 联合治疗的临床数据。本病例系列旨在评估临床实践中 anti-TNF-α 与 VDZ 联合治疗的安全性和临床反应。
所有从 2015 年 11 月至 2016 年 7 月开始接受 anti-TNF-α 和 VDZ 联合治疗的患者均进行前瞻性随访，至少随访 12 个月。
6 例溃疡性结肠炎患者和 4 例克罗恩病患者接受了联合治疗。这些患者的中位随访时间为 1712-20 个月。与单独使用 anti-TNF-α 相比，联合治疗期间未观察到更多预期之外的不良事件。随访结束时，所有患者均处于临床缓解状态，8 例患者可停用 anti-TNF-α 治疗并接受 VDZ 单药治疗。2 例克罗恩病患者需要联合治疗以维持缓解。
我们的研究结果表明，anti-TNF-α 与 VDZ 联合治疗是安全的，可能是某些患者的长期治疗选择。
