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Safety of dual biological therapy in Crohn’s disease: a case series of vedolizumab in combination with other biologics
  1. Eric J Mao1,
  2. Sara Lewin2,
  3. Jonathan P Terdiman2,
  4. Kendall Beck2
  1. 1 Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of California, Davis, Sacramento, California, USA
  2. 2 Department of Medicine, Division of Gastroenterology, University of California, San Francisco, San Francisco, California, USA
  1. Correspondence to Dr Eric J Mao; ejmao{at}


Uncertainty exists regarding safety and efficacy of dual biological therapy (DBT) in inflammatory bowel disease. We present four cases of DBT in Crohn’s disease. Three patients had refractory disease non-responsive to biological monotherapy or combination therapy with immunomodulators. One patient had concomitant ankylosing spondylitis. DBT was implemented by combining vedolizumab with an anti tumour necrosis antibody or with ustekinumab. DBT was well-tolerated, though two patients did experience self-limited infections. The efficacy of DBT remains unproven but it appears promising as three of the four patients achieved clinical remission. Our case series contributes insight into the safety of DBT that incorporates vedolizumab for future efficacy studies.

  • antibody targeted therapy
  • inflammatory bowel disease
  • adverse drug reactions

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  • Contributors EJM, SL, JPT and KB all participated in the planning and writing of this case series. EJM and KB are the contributors who are responsible for the overall content as guarantors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Author note EJM changed affiliations from University of California, San Francisco to University of California, Davis during the project.

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