{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:07:28Z","timestamp":1790892448280,"version":"4.1.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T00:00:00Z","timestamp":1604016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nontraditional combination of existing therapies is often the only option to avoid surgery in refractory inflammatory bowel disease (IBD) patients. We aim to assess the efficacy and safety of concomitant use of 2 biologic therapies or combination of biologic and tofacitinib in a refractory pediatric IBD cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>As part of an ongoing single-center observational cohort study of therapeutic outcomes in pediatric IBD patients (younger than 18 years), data were collected for patients receiving dual therapy. Primary outcome was 6 months of steroid-free remission. Secondary outcomes included time to steroid-free remission, change in serum biomarkers (C-reactive protein and erythrocyte sedimentation rate) and albumin between baseline and 6 months, and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen children (9 ulcerative colitis\/IBD-unspecified, 7 Crohn\u2019s disease), with a disease duration of 3 (2.1\u20135.0) years, initiated dual therapy at an age of 15.9 (13.5\u201316.8) years after failing \u22652 biologic therapies. Nine (56%) were treated with vedolizumab\/tofacitinib, 4 (25%) with ustekinumab\/vedolizumab, and 3 (19%) with ustekinumab\/tofacitinib. Twelve (75%; 7 ulcerative colitis\/IBD-unspecified, 5 Crohn\u2019s disease ) achieved steroid-free remission at 6 months. Erythrocyte sedimentation rate and C-reactive protein decreased (P = 0.021 and P = 0.015, respectively) and albumin increased (P = 0.003) between baseline and 6 months. One patient on 30 mg of vedolizumab\/tofacitinib and prednisone daily developed septic arthritis and a deep vein thrombosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data suggest that dual therapy may be an option for patients with limited therapeutic options remaining. Safety concerns should always be at the forefront of decision-making, and larger studies are needed to help confirm the preliminary safety data observed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izaa277","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T11:30:59Z","timestamp":1604057459000},"page":"1210-1214","source":"Crossref","is-referenced-by-count":83,"title":["Dual Biologic and Small Molecule Therapy for the Treatment of Refractory Pediatric Inflammatory Bowel Disease"],"prefix":"10.1093","volume":"27","author":[{"given":"Michael T","family":"Dolinger","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai , New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6787-1164","authenticated-orcid":false,"given":"Elizabeth A","family":"Spencer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai , New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai , New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dunkin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai , New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marla C","family":"Dubinsky","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai , New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,10,30]]},"reference":[{"key":"2022092009030614900_CIT0001","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1053\/j.gastro.2006.12.003","article-title":"Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn\u2019s disease in children","volume":"132","author":"Hyams","year":"2007","journal-title":"Gastroenterology."},{"key":"2022092009030614900_CIT0002","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.cgh.2011.11.026","article-title":"Induction and maintenance therapy with infliximab for children with moderate to severe ulcerative colitis","volume":"10","author":"Hyams","year":"2012","journal-title":"Clin Gastroenterol 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