Combination therapy for the treatment of Crohn’s disease

Abstract

Introduction: Crohn’s disease (CD) is an idiopathic inflammatory disorder of the gastrointestinal tract traditionally treated by the step-wise use of corticosteroids, antimetabolites and TNF-α antagonists. However, recent evidence indicates that the early introduction of drug combinations might be a superior strategy to step-care.

Areas covered: In this article, we review existing literature regarding the efficacy and safety of combination drug therapy for the management of CD. Five major databases: MEDLINE, EMBASE, PubMed, the Cochrane Library (CENTRAL) and DDW abstracts were electronically searched from inception to February 2015 for any relevant studies.

Expert opinion: Existing data strongly support the use of combination therapy for CD. The benefit of this approach appears to outweigh any associated risks. Until the role of gut selective therapies are better established, combination therapy should be considered the standard treatment approach for CD.

Keywords:

• combination therapy
• Crohn’s disease
• immunosuppressives
• monoclonal antibody
• therapy
• TNF antagonists

Acknowledgments

BG Feagan has received fee(s) from Abbott/AbbVie, Amgen, AstraZeneca, Avaxia Biologics Inc., Bristol-Myers Squibb, Celgene, Centocor Inc., Elan/Biogen, Ferring, JnJ/Janssen, Merck, Novartis, Novonordisk, Pfizer, Prometheus Laboratories, Protagonist, Salix Pharma, Takeda, Teva, Tillotts Pharma AG, UCB Pharma for Board membership; fee(s) from Abbott/AbbVie, Actogenix, Albireo Pharma, Amgen, AstraZeneca, Avaxia Biologics Inc., Axcan, Baxter Healthcare Corp., Boehringer-Ingelheim, Bristol-Myers Squibb, Calypso Biotech, Celgene, Elan/Biogen, EnGene, Ferring Pharma, Roche/Genentech, GiCare Pharma, Gilead, Given Imaging Inc., GSK, Ironwood Pharma, Janssen Biotech (Centocor), JnJ/Janssen, Kyowa Kakko Kirin Co Ltd., Lexicon, Lilly, Merck, Millennium, Nektar, Novonordisk, Pfizer, Prometheus Therapeutics and Diagnostics, Protagonist, Receptos, Salix Pharma, Serono, Shire, Sigmoid Pharma, Synergy Pharma Inc., Takeda, Teva Pharma, Tillotts, UCB Pharma, Vertex Pharma, Warner-Chilcott, Wyeth, Zealand, and Zyngenia for consultancy and lecture fee(s) from: Abbott/AbbVie, JnJ/Janssen, Takeda, Warner-Chilcott and UCB Pharma. All of these activities are outside the submitted work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was provided in the preparation of this manuscript.

Declaration of interest

BG Feagan has received grant/research support from Abbott/AbbVie, Janssen Biotech (Centocor), JnJ/Janssen, Millennium and UCB Pharma. He is a consultant for Abbott/AbbVie, Janssen Biotech (Centocor), JnJ/Janssen, Merck, Millennium, Prometheus Therapeutics and Diagnostics, Takeda and UCB Pharma. He has participated in speakers Bureaus for Abbott/AbbVie, JnJ/Janssen, Takeda, UCB Pharma and is a member of scientific advisory boards for Abbott/AbbVie, Merck, Prometheus Laboratories, Takeda and UCB Pharma. He is a member of the board of directors for Robarts Clinical Trials Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

Notes

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