Dual-targeted therapy with ustekinumab and vedolizumab as a novel rescue strategy: achieving high clinical response rates in Crohn’s disease refractory to both monotherapies
Chong Lu, Tao Ling, Yafang Li, Jiaojiao Wei, Yuan Chen, Jin Ding, Qunying WangBackground
Managing Crohn’s disease is challenging as a substantial proportion of patients lose response to biologics. This study evaluated dual targeted therapy (DTT) with ustekinumab (UST) and vedolizumab (VDZ) in patients refractory to both agents as monotherapies.
Methods
This retrospective study enrolled 23 patients with active Crohn’s disease and prior inadequate response to both UST and VDZ monotherapy. All patients initiated DTT following standard induction and maintenance protocols. The primary endpoint was clinical response at week 24. Secondary endpoints included clinical remission, biomarker normalization, endoscopic improvement, and safety.
Results
At week 24, DTT induced clinical response in 82.6% (19/23) and clinical remission in 34.8% (8/23) of patients, with all responders achieving corticosteroid-free remission. Inflammatory biomarkers significantly decreased: median C-reactive protein (CRP) from 11.6 to 3.5 mg/L (
Conclusion
UST and VDZ dual therapy effectively recaptured response and induced remission in Crohn’s disease patients failing both monotherapies, representing a promising rescue strategy for refractory Crohn’s disease that merits prospective validation.