Effectiveness and safety of dual advanced therapy in inflammatory bowel disease: a multicenter series from Galicia, Spain

• M.ª Teresa Diz-Lois Palomares ^[1] ; Carmen Pradera Cibreiro ^[2] ; Carmen Cabezal Iglesias ^[3] ; Manuel Barreiro de Acosta ^[4] ; Jesús Martínez Cadilla ^[5] ; Emilio Estévez Prieto ^[1] ; Rocío Ferreiro-Iglesias ^[4] ; Daniel Carpio López ^[3] ; Ana Echarri Piudo ^[2]
  1. [1] Complexo Hospitalario Universitario da Coruña

     Complexo Hospitalario Universitario da Coruña

     A Coruña, España

     
  2. [2] Complejo Hospitalario Universitario Ferrol. Ferrol, A Coruña
  3. [3] Complejo Hospitalario Universitario Pontevedra. Pontevedra, Spain
  4. [4] Complejo Hospitalario Universitario Santiago de Compostela. Santiago de Compostela, Spain
  5. [5] Complejo Hospitalario Universitario Vigo. Vigo, Spain

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• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 118, Nº. 3, 2026, págs. 131-138
• Idioma: inglés
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  • Background: approximately one-third of patients with inflammatory bowel disease (IBD) do not achieve disease control despite the incorporation of new advanced therapies in recent years. The combination of two advanced therapies (AT) can overcome this therapeutic ceiling; therefore, these therapies have been empirically tested in real-life clinical practice, but evidence is lacking on how and when to combine them. Methods: a multicenter retrospective study was designed, reviewing cases treated with dual advanced therapy (DAT). We examine its characteristics, effectiveness and adverse effects, and explore potential variables associated with its effectiveness. Results: a total of 29 DAT regimens were documented in 24 patients, with a median duration of seven months (IQR 0.5-43 months). Overall clinical remission was 41.1 % (36 % when DAT was indicated for refractory IBD, and 60 % when indicated for immune-mediated inflammatory diseases (IMID) and IBD. Endoscopic/radiological response was observed in 31.6 % of the evaluated patients (n = 19). In 17 cases (58.6 %), DAT was discontinued, three of them due to deep remission. The median survival without discontinuation due to inefficacy or adverse events was 20 months. No differences in effectiveness were observed based on the combined mechanisms of action, or on the strategy of adding new versus recycled AT. Conclusions: empirical use of DAT in refractory IBD may lead to clinical remission in approximately one-third of patients. Remission rates appeared more effective when DAT was used to simultaneously treat IBD and an IMID. However, further data are needed before specific recommendations can be made regarding type or timing strategy for DAT.