{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:54:07Z","timestamp":1781243647929,"version":"3.54.1"},"reference-count":10,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Gastroenterol"],"accepted":{"date-parts":[[2018,10,16]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>Uncertainty exists regarding safety and efficacy of dual biological therapy (DBT) in inflammatory bowel disease. We present four cases of DBT in Crohn\u2019s 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.<\/jats:p>","DOI":"10.1136\/bmjgast-2018-000243","type":"journal-article","created":{"date-parts":[[2018,11,9]],"date-time":"2018-11-09T23:55:15Z","timestamp":1541807715000},"page":"e000243","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Safety of dual biological therapy in Crohn\u2019s disease: a case series of vedolizumab in combination with other biologics"],"prefix":"10.1136","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0814-6496","authenticated-orcid":false,"given":"Eric J","family":"Mao","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of California, Davis, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Lewin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P","family":"Terdiman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendall","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,11,9]]},"reference":[{"key":"2025073013124710000_5.1.e000243.1","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/j.cgh.2016.04.039","article-title":"Biologic therapies and risk of infection and malignancy in patients with inflammatory bowel disease: a systematic review and network meta-analysis","volume":"14","author":"Bonovas","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025073013124710000_5.1.e000243.2","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1038\/ajg.2016.66","article-title":"Ustekinumab and anti-TNF combination therapy in patients with inflammatory bowel disease","volume":"111","author":"Yzet","year":"2016","journal-title":"Am J Gastroenterol"},{"key":"2025073013124710000_5.1.e000243.3","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20014"},{"key":"2025073013124710000_5.1.e000243.4","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1038\/ajg.2015.355","article-title":"Vedolizumab and infliximab combination therapy in the treatment of crohn's disease","volume":"110","author":"Hirten","year":"2015","journal-title":"Am J Gastroenterol"},{"key":"2025073013124710000_5.1.e000243.5","doi-asserted-by":"crossref","unstructured":"Christensen B , Gibson P , Micic D , et al . Safety and efficacy of combination treatment with calcineurin inhibitors and vedolizumab in patients with refractory inflammatory bowel disease. Clin Gastroenterol Hepatol 2018.doi:10.1016\/j.cgh.2018.04.060","DOI":"10.1016\/j.cgh.2018.04.060"},{"key":"2025073013124710000_5.1.e000243.6","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1093\/ibd\/izx110","article-title":"Combining anti-TNF-\u03b1 and vedolizumab in the treatment of inflammatory bowel disease: a case series","volume":"24","author":"Buer","year":"2018","journal-title":"Inflamm Bowel Dis"},{"key":"2025073013124710000_5.1.e000243.7","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1093\/ecco-jcc\/jjx142","article-title":"Co-treatment with golimumab and vedolizumab to treat severe UC and associated spondyloarthropathy","volume":"12","author":"Roblin","year":"2018","journal-title":"J Crohns Colitis"},{"key":"2025073013124710000_5.1.e000243.8","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2016-000127"},{"key":"2025073013124710000_5.1.e000243.9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2017\/5264216","article-title":"Ustekinumab and Vedolizumab Dual Biologic Therapy in the Treatment of Crohn's Disease","volume":"2017","author":"Liu","year":"2017","journal-title":"Case Rep Med"},{"key":"2025073013124710000_5.1.e000243.10","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1016\/j.cgh.2018.02.024","article-title":"Combining biologics in inflammatory bowel disease and other immune mediated inflammatory disorders","volume":"16","author":"Hirten","year":"2018","journal-title":"Clin Gastroenterol Hepatol"}],"container-title":["BMJ Open Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjgast-2018-000243","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T20:12:52Z","timestamp":1753906372000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopengastro.bmj.com\/lookup\/doi\/10.1136\/bmjgast-2018-000243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,11,9]]},"published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1136\/bmjgast-2018-000243"],"URL":"https:\/\/doi.org\/10.1136\/bmjgast-2018-000243","relation":{},"ISSN":["2054-4774"],"issn-type":[{"value":"2054-4774","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11]]}}}