Beyond class switching in multi-refractory inflammatory bowel disease: Nine case reports and review of literature

What To Know

This article reports nine case reports of multi-refractory IBD patients (5 UC, 4 Crohn’s) treated with advanced combination therapy (ACT): an oral JAK inhibitor added to a biologic after incomplete response.

Reported combinations include infliximab+tofacitinib, ustekinumab+tofacitinib, vedolizumab+JAK inhibitor, upadacitinib+adalimumab, and guselkumab+tofacitinib. Eight of nine patients had clinical response and six achieved documented deep remission by the authors; one patient proceeded to colectomy.

The paper is a case-series (abstract-level summary provided) describing phenotype-driven selection, objective reassessment (clinical, biochemical, endoscopic), and safety observations in a small, selected cohort. It does not establish efficacy or safety in broader populations.

Clinicians managing multi-refractory IBD, patients considering or currently on biologics/JAK inhibitors, and researchers studying combination approaches. This is a small case series reported in a journal abstract/full-text; findings are observational, uncontrolled, and subject to selection bias.

Reported safety was limited in this cohort but larger studies are needed to assess risks of combination biologic+JAK therapy.