Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Combination Therapy & Risk of IBD Complications

Clin Gastroenterol Hepatol; ePub 2018 Nov 15; Targownik, et al

Initiation therapy with a combination immune modulators and anti-TNF agents in patients with inflammatory bowel disease (IBD) was associated with a decreased likelihood of treatment ineffectiveness for patients with Crohn’s disease (CD) but not ulcerative colitis (UC). This according to a population cohort study in which researchers collected data from persons with CD (n=852) or UC (n=303) from 2001 through 2016 who began treatment with a TNF antagonist. New and/or continuing users of immunomodulators at the time anti-TNF therapy began were considered recipients of combination therapy. They found:

  • In patients with CD, combination therapy was associated with a significant decrease in the likelihood of treatment ineffectiveness.
  • However, this association was not significant in patients with UC.
  • Combination therapy in those the CD was also associated with increased time to first IBD-related hospitalization and switching anti-TNF agents, but not with IBD-related surgery.


Targownik LE, Benchimol EI, Bernstein CN, et al. Upfront combination therapy, compared with monotherapy, for patients not previously treated with a biologic agent associated with reduced risk of inflammatory bowel disease-related complications in a population-based cohort study. [Published online ahead of print November 15, 2018]. Clin Gastroenterol Hepatol. doi:10.1016/j.cgh.2018.11.003.