Efficacy and Safety of Dual-Targeted Therapy for Refractory Inflammatory Bowel Disease: A Retrospective Case Series from Three Tertiary General Hospitals In China

xiaoying wang¹ye fang²yongli ye³shuyan li⁴dingting xu⁴xiaoqi zhang⁵Yi Jiang²Yan Chen^1*

• ¹Department of Gastroenterology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Jiangsu Province, China
• ²Department of Gastroenterology, Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
• ³Endoscopy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
• ⁴Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
• ⁵Department of Gastroenterology, Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China

Dual-targeted therapy (DTT) may be a promising approach to refractory inflammatory bowel disease (IBD). The aim of this case series was to evaluate the safety and clinical response of DTT in clinical practice.We retrospectively analyzed data from refractory inflammatory bowel disease (IBD) patients receiving dual-target therapy (DTT) across Chinese IBD centers.Treatment combinations included biologics (infliximab, adalimumab, vedolizumab, ustekinumab) and the oral small molecule (tofacitinib). We collected baseline characteristics, clinical and endoscopic activity indices, inflammatory markers (Creactive protein, albumin), and adverse events to evaluate the clinical effectiveness, endoscopic response, biochemical remission, and safety profile of DTT.Eight patients with ulcerative colitis (UC) and ten with Crohn's disease (CD) underwent DTT across three tertiary hospitals in China. All corticosteroids initiated at baseline (6 cases) were completely discontinued within three months. Clinical response rates were 88.23% (15/17), 91.67% (11/12), and 100% (7/7) at 3, 6, and 9 months respectively. Endoscopic response was achieved in 88.89% (8/9) of patients evaluated at 9 months. Adverse events included ustekinumab-associated arthralgia and alopecia in one UC patient and tofacitinib-related allergic purpura in another; both subsequently transitioned to monotherapy. Two CD patients developed infections (C. difficile and bacterial enteritis) in the third month, were treated with oral antibiotics, and successfully continued their original DTT regimens. 删除了: response 删除了: and Results 删除了: small molecule 设置了格式: 默认段落字体, 字体: 加粗, (中文) 中文 (台湾) 设置了格式: 突出显示Our findings suggest that dual-target therapy demonstrates promising efficacy and an acceptable safety profile in refractory IBD patients. DTT may represent a valuable therapeutic option for patients who have failed conventional monotherapies.