Department of Gastroenterology and Digestive Endoscopy, IRCCS "Casa Sollievo della Sofferenza" Hospital, Viale dei Cappuccini, San Giovanni Rotondo, Foggia.
Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
Eur J Gastroenterol Hepatol. 2020 Dec;32(12):1579-1582. doi: 10.1097/MEG.0000000000001919.
Inflammatory bowel disease (IBD) is a chronic and disabling disorder. Severity of IBD is prominent among refractory with patients with concomitant immune-mediated disorders. Among those patients, dual biological therapy (DBT) has been suggested as an alternative approach to spare steroids and avoid surgery. However, pieces of evidence on clinical outcomes among patients receiving DBT are still limited. We present two cases of IBD patients, with dermatological comorbidity, treated with a combination of vedolizumab and ustekinumab, identifying possible landmarks to address therapeutic choice. No patient experienced adverse events in the follow-up period and both obtained complete clinical remission. DBT may be an effective approach to consider in selected patients with refractory IBD with concomitant severe immune-mediated diseases taking into account medical history of the patient, presence, and type of concomitant extraintestinal manifestations, safety profile of selected DBT, licensed therapeutic indications, and costs.
炎症性肠病（IBD）是一种慢性且使人丧失能力的疾病。在伴有免疫介导性疾病的难治性患者中，IBD 的严重程度较为突出。对于这些患者，双生物疗法（DBT）已被建议作为一种替代方法，以避免使用类固醇和手术。然而，关于接受 DBT 的患者的临床结局的证据仍然有限。我们介绍了两例患有皮肤病的 IBD 患者，他们接受了维多珠单抗和乌司奴单抗联合治疗，确定了可能的治疗选择的关键点。在随访期间，没有患者发生不良事件，并且两者均获得了完全的临床缓解。在考虑到患者的病史、同时存在的和类型的伴发的肠外表现、所选 DBT 的安全性概况、许可的治疗适应症和成本的情况下，DBT 可能是一种有效的方法，适用于伴有严重免疫介导性疾病的难治性 IBD 患者。
