The burden of inflammatory bowel disease (IBD) is increasing globally and imposes a high morbidity in patients with IBD. Advances have been made in medical management of IBD with the advent of novel therapies such as the biologics and small molecule drugs (SMDs). However, response to these medications is limited; with only 40% of patients achieving clinical remission at 1 year with a biologic. Hence, medical management of IBD is a rapidly evolving paradigm in which not only are new medications being developed but understanding how, when and in whom to use them is evolving. Dual targeted therapy (DTT), which is the combination of biologics and/or SMDs is an attractive concept as it is theoretically a potent and multidimensional anti-inflammatory treatment strategy. In this review, we present the published literature on the use of DTT and highlight its utility in clinical practice. The majority of studies on DTT are case reports and case series on the combination of dual biologic therapy. From the limited evidence available in patients with IBD, dual biologic therapy may be a safe option for patients with refractory IBD who have failed multiple biologic therapies and to manage extraintestinal manifestation of IBD. There are a handful of reports of combination therapy with a biologic and a SMD in patients with IBD. Further studies and randomized control trials are required to comprehensivretain hereely evaluate the safety and efficacy of DTT in IBD.

中文翻译：

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炎症性肠病的双靶向治疗。

炎症性肠病 (IBD) 的负担在全球范围内不断增加，并且 IBD 患者的发病率很高。随着生物制剂和小分子药物 (SMD) 等新型疗法的出现，IBD 的医疗管理取得了进展。然而，这些药物的反应有限；仅 40% 的患者在使用生物制剂 1 年后获得临床缓解。因此，IBD 的医疗管理是一个快速发展的范例，其中不仅不断开发新药物，而且了解如何、何时以及在谁中使用这些药物也在不断发展。双靶向治疗 (DTT) 是生物制剂和/或 SMD 的组合，是一个有吸引力的概念，因为它在理论上是一种有效的多维抗炎治疗策略。在这篇综述中，我们介绍了有关 DTT 使用的已发表文献，并强调了其在临床实践中的实用性。大多数DTT研究都是关于双生物治疗联合的病例报告和病例系列。从 IBD 患者现有的有限证据来看，对于多种生物治疗失败的难治性 IBD 患者以及控制 IBD 肠外表现的难治性 IBD 患者来说，双重生物治疗可能是一种安全的选择。有一些关于生物制剂和 SMD 联合治疗 IBD 患者的报道。需要进一步的研究和随机对照试验来全面评估 DTT 在 IBD 中的安全性和有效性。