A growing number of patients with Crohn’s disease and ulcerative colitis have disease that is refractory to multiple advanced therapies, have undergone multiple surgeries, and require further treatment options. For this reason, there has been increasing use of multiple simultaneous advanced targeted therapies. Although the knowledge on combined advanced targeted therapy (CATT) in inflammatory bowel disease (IBD) has been largely limited to observational data and early-phase randomized controlled trials, combination of therapies is commonplace in many other diseases. This review discusses conceptual frameworks of CATT in IBD, provides context of combined therapies in other diseases, provides current evidence for CATT in IBD, and projects future applications and positioning of CATT using existing, novel, and orthogonal mechanisms of action. CATT aims to address the need to overcome low efficacy rates and frequent loss of response of current individual therapies. Both treatment exposure and disease duration are major determinants of response to therapy. Identification of safe and effective CATT may impact positioning of this strategy to apply to a broader IBD population.

中文翻译：

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IBD 对接会 - 合理联合治疗


越来越多的克罗恩病和溃疡性结肠炎患者患有多种先进疗法难以治愈的疾病，已经接受了多次手术，并且需要进一步的治疗选择。因此，多种同时先进靶向治疗的使用越来越多。尽管对炎症性肠病（IBD）联合先进靶向治疗（CATT）的了解很大程度上仅限于观察数据和早期随机对照试验，但联合治疗在许多其他疾病中很常见。这篇综述讨论了 CATT 在 IBD 中的概念框架，提供了其他疾病联合治疗的背景，提供了 CATT 在 IBD 中的当前证据，并利用现有的、新颖的和正交的作用机制预测了 CATT 的未来应用和定位。 CATT 旨在解决当前个体疗法的低有效率和频繁失去反应的问题。治疗暴露和疾病持续时间都是治疗反应的主要决定因素。安全有效的 CATT 的确定可能会影响该策略的定位，以适用于更广泛的 IBD 人群。