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Copyright ©The Author(s) 2017.
World J Gastrointest Pharmacol Ther. May 6, 2017; 8(2): 103-113
Published online May 6, 2017. doi: 10.4292/wjgpt.v8.i2.103
Table 1 Author’s summary of the evidence for combination therapy
Crohn’s disease
Ulcerative colitis
Clinical benefitPharmacokinetic/immunogenic benefitClinical benefitPharmacokinetic/immunogenic benefit
IFX + AZA/6MP (treatment naïve)++++
IFX + AZA/6MP (step-up from immunomodulator monotherapy)-NANANA
IFX + MTX+/-+NANA
ADA + IMM+/-+/-NANA
VDZ + IMMNA+NANA
Ustekinumab +NANANANA
IMM
Table 2 Summary: Major society guidelines addressing combination therapy
CDUC
American College of Gastroenterology (2009 CD, 2010 UC)IFX or IFX and AZA superior to AZAUnknown efficacy of CT
European Crohn’s and Colitis Organization and World Congress of Gastroenterology (2011)IFX and AZA superior to monotherapy (in treatment naïve)Unknown efficacy of CT
American Gastroenterological Association (CD guidelines (2013)Anti-TNF-α and AZA superior to monotherapy
American Gastroenterological Association Clinical Care Pathways (2014 CD, 2015 UC)Consider IMM with anti-TNF-α or 2nd/3rd line biologicConsider IMM with all anti-TNF-α or VDZ use
Hong Kong IBD Society (2013)Anti-TNF-α and AZA superior to monotherapyCT not addressed
Indian Society of Gastroenterology (UC consensus)CT not addressed
Asian Pacific Association of Gastroenterology (UC consensus)CT not addressed
Japanese Society of Gastroenterology (CD guidelines)CT Not addressed