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Reaching the therapeutic ceiling in IBD: Can Advanced Combination Treatment (ACT) offer a solution?
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DOI：10.1016/j.bpg.2025.101981.png)
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Abstract
En 中文
• Combination Approaches: Advanced Combination Treatment (ACT) has emerged as the preferred terminology, emphasizing a strategic focus on leveraging multiple therapeutic mechanisms for more effective disease control. • Viable Treatment Option: Current evidence supports ACT as a promising alternative for IBD patients, offering targeted treatment that contrasts with traditional monotherapy strategies. • Ideal Candidates: ACT should be prioritized for patients with refractory disease, high-risk phenotypes, or concomitant EIMs or IMIDs, where conventional therapies have failed or are unlikely to succeed. • Optimal Timing and Setting: Begin combination therapy when disease risks outweigh treatment risks, and ideally in specialized centres with multidisciplinary teams for comprehensive care and access to clinical trials. • Monitoring and Adjustment: Regularly reassess treatment every six months to ensure efficacy and safety. Adjust or discontinue agents as necessary, and prioritize therapies with well-established safety profiles, such as vedolizumab or ustekinumab, when possible.
Keywords:
Dual
Immune-mediated inflammatory diseases
Therapeutic ceiling
Crohn's disease
Ulcerative colitis
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