Emerging role of dual biologic therapy for the treatment of inflammatory bowel disease

Table 1 Summary of trials, case reports and retrospective studies on dual biological therapy for inflammatory bowel disease

Ref.	Study type	No. of patients	Disease	Treatment used
Sands et al[14], 2007	RCT	79	CD	IFX + natalizumab
Anita and Michael[16], 2016	CR	1	CD	VDZ + ADA
Bethge et al[17], 2017	CR	1	UC	VDZ + ETN
Liu and Loomes[9], 2017	CR	1	CD	UST + VDZ
Huff-Hardy et al[10], 2017	CR	1	CD	UST + VDZ
Roblin et al[19], 2018	CR	1	UC	GOL + VDZ
Buer et al[20], 2018	CS	10	4 × CD, 6 × UC	Anti-TNF + VDZ
Mao et al[21], 2018	CS	4	CD	VDZ + UST/GOL
Olbjørn et al[11], 2020	CS	13	9 × CD, 4 × UC	IFX + UST/VDZ
Glassner et al[22], 2020	Retrospective	50	CD + UC	UST + ANTI-TNF/VDZ, tofacitinib + VDZ/UST/anti-TNF, Cyclosporin, rituximab, SEC, leflunomide, tacrolimus
Yang et al[23], 2020	Retrospective	22	CD	VDZ + UST/anti-TNF, UST + anti-TNF
Privitera et al[24], 2020	Retrospective	16	11 × CD, 5 × UC	UST + CZP/IFX/ADA/VDZ, VDZ + ADA/SEC/IFX/CZP/aprelimast
Kwapisz et al[26], 2021	Retrospective	15	14 × CD, 1 × UC	VDZ + anti-TNF/UST, UST + anti-TNF/VDZ
Goessens et al[27], 2021	Retrospective	98	58 × CD, 40 × UC	ADA + VDZ/UST, VDZ + INF + azathioprine, VDZ + UST + azathioprine, UST + ETN, IFX + VDZ + methotrexate, CZP + VDZ + methotrexate
No author listed[15], 2022	RCT	214	UC	GOL + guselkumab

ADA: Adalimumab; CD: Crohn’s disease; CR: Case report; CS: Case series; CZP: Certolizumab; ETN: Etanercept; GOL: Golimumab; IBD: Inflammatory bowel disease; IFX: Infliximab; RCT: Randomised controlled trial; SEC: Secukinumab; TNF: Tumour necrosis factor; UC: Ulcerative colitis; UST: Ustekinumab; VDZ: Vedolizumab.

Table 2 Summary of infections reported in randomised controlled trial and case studies of patients on dual biologic therapy for inflammatory bowel disease

Ref.	Infections documented
Sands et al[14], 2007	Nasopharyngitis
Buer et al[20], 2018	Tonsillitis × 2
	Sinusitis × 1
Olbjørn et al[11], 2020	Skin infection
Mao et al[21], 2018	Clostridium difficile × 2
	Hand, foot and mouth disease
	Influenza
Yang et al[23], 2020	Pneumonia
	Clostridium difficile
	Actinetobacter bacteraemia
Privitera et al[24], 2020	Perianal abscess
Kwapisz et al[26], 2021	Salmonella
	Clostridium difficile
	4 × patients needing antibiotics
Goessens et al[27], 2021	Osteomyelitis
	Enterocutaneous fistula infection
	Perianal abscess
	Viral URTI
	Campylobacter
	Pneumonia
	Herpetic meningoencephalitis
	Oesophageal candidiasis
	Influenza

URTI: Upper respiratory tract infections.