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World J Gastroenterol. Dec 21, 2022; 28(47): 6743-6751
Published online Dec 21, 2022. doi: 10.3748/wjg.v28.i47.6743
Role of the combination of biologics and/or small molecules in the treatment of patients with inflammatory bowel disease
Domingo Balderramo
Domingo Balderramo, Department of Gastroenterology, Hospital Privado Universitario de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba 5016, Argentina
Author contributions: Balderramo D performed the writing and editing of the manuscript and prepared the figure and table.
Conflict-of-interest statement: Balderramo D reports receiving payment for speaker´s fee from AbbVie, Takeda, and Janssen, and receiving consulting fees from AbbVie, Takeda, Janssen, and Amgen.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Domingo Balderramo, MD, PhD, Professor, Department of Gastroenterology, Hospital Privado Universitario de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Naciones Unidas 346, Córdoba 5016, Argentina. dbalderramo@hospitalprivadosa.com.ar
Received: September 22, 2022
Peer-review started: September 22, 2022
First decision: October 18, 2022
Revised: October 26, 2022
Accepted: November 27, 2022
Article in press: November 27, 2022
Published online: December 21, 2022
Core Tip

Core Tip: Patients with inflammatory bowel disease (IBD) require prolonged treatment and high utilization of healthcare resources. About 40% of patients are refractory to different treatments with an increase need for hospitalization and surgery. Dual therapy, a strategy applicable to refractory IBD patients, includes the combination of two biologics or a biologic in combination with a small molecule drug. There are two distinct scenarios in IBD therapy in which this approach can be used: (1) Refractory active luminal disease without extraintestinal manifestations; and (2) patients with IBD in remission, but with active extraintestinal manifestations or immune-mediated inflammatory diseases.