Kamal A El-Atrebi*, Rahma Ali and Hala T El-Bassyouni

Department of General Medicine and Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Eg

*Corresponding Author: Kamal A El-Atrebi, Department of General Medicine and Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Egypt.

Received: May 24, 2024; Published: June 03, 2024

Abstract

Background: A promising approach for treating refractory IBD involves the use of a combination of two biological agents and/or small molecules. This study aimed to assess the effectiveness of low-dose combination biologic therapy for treating refractory IBD patients.

Methods: This study assessed five refractory IBD patients who previously failed one to four biologics (IFX, ADA, UST, VEDO, or tofacitinib) on standard-dose and standard-duration treatment regimens. The patients underwent clinical examination, CRP, calprotectin, upper endoscopy, and quality of life evaluation. To introduce a low-dose treatment, a novel strategy was developed that combines a standard maintenance dose (no loading dose) of one biologic (Infliximab, Adalimumab, or Ustikenomab) with a maintenance dose of 15 mg of upacitinib per day.

Results: After one month and three months of follow-up, the patients were evaluated for clinical indices, biomarkers (CRP and calprotectin), colonoscopy, and quality of life. All patients showed rapid improvement in their disease activity, normalization of their biomarkers of disease activity, and quality of life. After three months of follow-up, the colonoscopic findings showed obvious improvement.

Conclusion: The introduction of a combination of biological and small molecules at standard maintenance doses (no loading doses) is an interesting concept with potential benefits, as it provides rapid and effective management of refractory IBD patients and improved quality of life.

Keywords: Biologics; Combination Therapy; Small Molecule Drugs

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Citation

Citation: Kamal A El-Atrebi., et al. “Combination of Biologics and Small Molecules in Inflammatory Bowel Disease: New Trends in Low Doses". Acta Scientific Gastrointestinal Disorders 7.7 (2024): 04-09.

Copyright

Copyright: © 2024 Kamal A El-Atrebi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.