{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:13:08Z","timestamp":1787850788166,"version":"build-2784847793"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Combining advanced therapies may improve outcomes in inflammatory bowel disease (IBD), but there are little data on the effectiveness and safety of this approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We examined outcomes of patients who received vedolizumab in combination with another biologic or tofacitinib between 2016 and 2020.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fourteen patients (10 ulcerative colitis [UC], 3 Crohn disease, 1 indeterminate colitis) received a combination of advanced therapies. Vedolizumab was combined with tofacitinib in 9 patients, ustekinumab in 3, and adalimumab in 2. Median follow-up on combination therapy was 31 weeks. Normalization of C-reactive protein (CRP) or fecal calprotectin (&amp;lt;5 mg\/L and &amp;lt;150 \u00b5g\/g, respectively) was achieved in 56% (5\/9) and 50% (4\/8) of patients. Paired median CRP decreased from 14 mg\/L to &amp;lt;5 mg\/L with combination therapy (n = 9, P = 0.02), and paired median calprotectin from 594 \u00b5g\/g to 113 \u00b5g\/g (n = 8, P = 0.12). Among patients with UC, paired median Lichtiger score decreased from 9 to 3 (n = 7, P = 0.02). Prednisone discontinuation was achieved in 67% (4\/6) of prednisone-dependent patients. There were 4 infections: 2 required hospitalization (rotavirus, Clostridium difficile), and 2 did not (pneumonia, sinusitis). During follow-up, 5\/14 patients discontinued combination therapy (2 nonresponse; 1 improvement and de-escalation; 1 noninfectious adverse effect; 1 loss of coverage).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this retrospective case series of a cohort with refractory IBD, combining vedolizumab with other biologics or tofacitinib improved inflammatory markers, reduced clinical disease activity and steroid use, and was well tolerated.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/crocol\/otab030","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T19:22:02Z","timestamp":1622056922000},"source":"Crossref","is-referenced-by-count":25,"title":["Favorable Outcomes Combining Vedolizumab With Other Biologics or Tofacitinib for Treatment of Inflammatory Bowel Disease"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7536-1722","authenticated-orcid":false,"given":"Ernesto M","family":"Llano","sequence":"first","affiliation":[{"name":"Division of Digestive Liver Diseases, UT Southwestern Medical Center , Dallas, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreeju","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Division of Digestive Liver Diseases, UT Southwestern Medical Center , Dallas, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezra","family":"Burstein","sequence":"additional","affiliation":[{"name":"Division of Digestive Liver Diseases, UT Southwestern Medical Center , Dallas, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moheb","family":"Boktor","sequence":"additional","affiliation":[{"name":"Division of Digestive Liver Diseases, UT Southwestern Medical Center , Dallas, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David I","family":"Fudman","sequence":"additional","affiliation":[{"name":"Division of Digestive Liver Diseases, UT Southwestern Medical Center , Dallas, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"2022111812281995000_CIT0001","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1038\/ajg.2018.27","article-title":"ACG clinical guideline: management of Crohn\u2019s disease in adults","volume":"113","author":"Lichtenstein","year":"2018","journal-title":"Am J Gastroenterol."},{"key":"2022111812281995000_CIT0002","doi-asserted-by":"crossref","first-page":"384","DOI":"10.14309\/ajg.0000000000000152","article-title":"ACG clinical guideline: ulcerative colitis in adults","volume":"114","author":"Rubin","year":"2019","journal-title":"Am J 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