Back to the drawing board: Overview of the next generation of combination therapy for inflammatory bowel disease

Abstract

Inflammatory bowel disease (IBD) is entering a potentially new era of combined therapeutics. Triantafillidis et al provide an insightful review of the current state of combination therapy, with a focus on the use of a combined biologic and immunomodulator, as well as emerging data on the future potential of dual-biologic therapy (DBT). While current evidence for DBT is limited, encouraging safety profiles and ongoing trials suggest a brighter future for this approach. The importance of controlled trials should be stressed in establishing new treatment paradigms. Ongoing prospective randomized trials of DBT and perhaps future combinations of biologics and small molecule therapies will hopefully guide the next generation of IBD care.

Keywords: Inflammatory bowel disease; Biologics; Immunomodulators; Dual-therapy; Combination therapy

Core Tip: Triantafillidis et al thoroughly collate important studies summarizing the available evidence supporting the combination of various therapeutics used in the treatment of inflammatory bowel disease (IBD). Specifically highlighted is the importance of exploring combination therapy with biologics and immunomodulators, and in particular the emerging role of dual-biologic therapy (DBT). Given that current evidence for DBT is limited and new biologics continue to be developed, there is an urgent need for high-quality prospective trials to establish new treatment paradigms for the next generation of IBD care.