Abdullah Israa, AlMojil Khaled, Shehab Mohammad
Department of Pharmacy, Clinical Pharmacy Unit, Kuwait Hospital, Sabah Al-Salem 44001, Kuwait.
Division of Gastroenterology, Department of Internal Medicine, Mubarak Alkabeer University Hospital, Kuwait University, Jabriya 47060, Kuwait.
Diseases. 2022 Nov 9;10(4):102. doi: 10.3390/diseases10040102.
Inflammatory bowel disease (IBD) is a chronic autoimmune disease with relapse-remission courses. A number of patients may present with a refractory disease with partial or no response to treatment. Others may present with extra-intestinal manifestations that makes the treatment with one biologic challenging. Dual target therapy (DTT), combining biologics and/or small molecule drugs, may offer a chance to achieve remission in these cases and improve patients' quality of life despite the limited evidence regarding this approach. We present a case series of refractory inflammatory bowel disease cases managed with DTT. Seven patients with refractory IBD achieved steroid free, clinical, and endoscopic remission by using DTT. These results support that DTT could be an effective approach in selected patients with refractory IBD or with concomitant extra-intestinal manifestations (EIM). Larger studies, ideally randomized controlled trials, are needed to further support the evidence and confirm the efficacy and safety of DTT for IBD.
炎症性肠病（IBD）是一种具有复发-缓解病程的慢性自身免疫性疾病。许多患者可能表现为难治性疾病，对治疗部分或完全无反应。其他患者可能出现肠外表现，这使得使用一种生物制剂进行治疗具有挑战性。联合使用生物制剂和/或小分子药物的双靶点治疗（DTT），尽管关于这种方法的证据有限，但可能为这些患者提供实现缓解并改善生活质量的机会。我们展示了一系列采用DTT治疗的难治性炎症性肠病病例。7例难治性IBD患者通过使用DTT实现了无类固醇、临床和内镜缓解。这些结果支持DTT可能是治疗部分难治性IBD患者或伴有肠外表现（EIM）患者的有效方法。需要开展更大规模的研究，理想情况下是随机对照试验，以进一步支持相关证据，并确认DTT治疗IBD的疗效和安全性。
