Mas Eduard Brunet, Calvo Xavier Calvet
Servei Aparell Digestiu, Hospital Universitari Parc Taulí, 08208 Sabadell, Spain.
Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
J Clin Med. 2022 Feb 18;11(4):1076. doi: 10.3390/jcm11041076.
Current medical treatment for inflammatory bowel disease (IBD) does not achieve 100% response rates, and a subset of refractory and severely ill patients have persistent active disease after being treated with all possible drug alternatives. The combination of two biological therapies (CoT) seems a reasonable alternative, and has been increasingly tested in very difficult cases. The present review suggests that CoT seems to be safe and effective for refractory and severely ill IBD patients. Ustekinumab plus vedolizumab and vedolizumab plus anti-TNF were the most used CoTs for Crohn's disease. For ulcerative colitis, the most used CoTs were vedolizumab plus anti-TNF and vedolizumab plus tofacitinib. The aforesaid CoTs have shown good efficacy and few adverse events have been reported.
目前针对炎症性肠病（IBD）的医学治疗并未达到100%的有效率，一部分难治性和重症患者在接受了所有可能的药物替代治疗后仍患有持续性活动性疾病。两种生物疗法联合使用（CoT）似乎是一种合理的替代方案，并且已经在非常困难的病例中进行了越来越多的试验。本综述表明，CoT对难治性和重症IBD患者似乎是安全有效的。乌司奴单抗联合维多珠单抗以及维多珠单抗联合抗TNF是克罗恩病最常用的CoT组合。对于溃疡性结肠炎，最常用的CoT组合是维多珠单抗联合抗TNF以及维多珠单抗联合托法替布。上述CoT组合已显示出良好的疗效，并且报告的不良事件较少。
