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Комбинированная терапия болезни Крона ингибитором интерлейкина 12/23 и таргетным иммуносупрессором. Клинические наблюдения
Комбинированная терапия болезни Крона ингибитором интерлейкина 12/23 и таргетным иммуносупрессором. Клинические наблюдения
Князев О.В., Каграманова А.В., Лищинская А.А., Сабельникова Е.А., Лазука Н.В., Парфенов А.И. Комбинированная терапия болезни Крона ингибитором интерлейкина 12/23 и таргетным иммуносупрессором. Клинические наблюдения. Consilium Medicum. 2025;27(5):274–278. DOI: 10.26442/20751753.2025.5.203290
© ООО «КОНСИЛИУМ МЕДИКУМ», 2025 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2025 г.
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Аннотация
В последние годы опубликовано несколько клинических исследований, обзоров и клинических наблюдений двойной биологической терапии – одновременного применения двух генно-инженерных биологических препаратов и/или таргетных иммуносупрессоров при болезни Крона (БК). В статье приведены клинические наблюдения двойной биологической терапии упадацитинибом и устекинумабом пациентов с тяжелой формой БК, которой предшествовала генно-инженерная биологическая терапия. Через 26 нед комбинированной терапии у всех пациентов достигнута клинико-эндоскопическая и иммунобиологическая ремиссия БК без развития серьезных нежелательных явлений.
Ключевые слова: болезнь Крона, упадацитиниб, устекинумаб
Keywords: Crohn's disease, upadacitinib, ustekinumab
Ключевые слова: болезнь Крона, упадацитиниб, устекинумаб
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Keywords: Crohn's disease, upadacitinib, ustekinumab
Полный текст
Список литературы
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3. Ahmed W, Galati J, Kumar A, et al. Dual Biologic or Small Molecule Therapy for Treatment of Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2022;20(3):e361-39. DOI:10.1016/j.cgh.2021.03.034
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8. Kwapisz L, Raffals LE, Bruining DH, et al. Combination Biologic Therapy in Inflammatory Bowel Disease: Experience From a Tertiary Care Center. Clin Gastroenterol Hepatol. 2021;19(3):616-1. DOI:10.1016/j.cgh.2020.02.017
9. Sands BE, Kozarek R, Spainhour J, et al. Safety and tolerability of concurrent natalizumab treatment for patients with Crohn's disease not in remission while receiving infliximab. Inflamm Bowel Dis. 2007;13(1):2-11. DOI:10.1002/ibd.20014
10. Yang E, Panaccione N, Whitmire N, et al. Efficacy and safety of simultaneous treatment with two biologic medications in refractory Crohn's disease. Aliment Pharmacol Ther. 2020;51(11):1031-8. DOI:10.1111/apt.15719
11. Honap S, Netter P, Danese S, Peyrin-Biroulet L. An update on the safety of long-term vedolizumab use in inflammatory bowel disease. Expert Opin Drug Saf. 2023;22(9):767-76. DOI:10.1080/14740338.2023.2247976
12. Avedillo-Salas A, Corral-Cativiela S, Fanlo-Villacampa A, Vicente-Romero J. The Efficacy and Safety of Biologic Drugs in the Treatment of Moderate-Severe Crohn's Disease: A Systematic Review. Pharmaceuticals (Basel). 2023;16(11):1581. DOI:10.3390/ph16111581
13. Miyatani Y, Choi D, Choi NK, Rubin DT. Dual-Targeted Therapy with Upadacitinib and Ustekinumab in Medically Complex Crohn's Disease. Dig Dis Sci. 2024;69(2):355-5. DOI:10.1007/s10620-023-08182-y
14. Harvey Bradshaw Index for Crohn’s disease calculator. Available at: https://www.thecalculator.co/health/Harvey-Bradshaw-Index-For-Crohn%E2%80%99s-Disease-Calculator-103.... Accessed: 25.04.2025.
15. Daperno M, D'Haens G, Van Assche G, et al. Development and validation of a new, simplified endoscopic activity score for Crohn's disease: the SES-CD. Gastrointest Endosc. 2004;60(4):505-12. DOI:10.1016/s0016-5107(04)01878-4
2. Haider M, Lashner B. Dual Targeted Therapy for the Management of Inflammatory Bowel Disease. J Clin Gastroenterol. 2021;55(8):661-6. DOI:10.1097/MCG.0000000000001583
3. Ahmed W, Galati J, Kumar A, et al. Dual Biologic or Small Molecule Therapy for Treatment of Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2022;20(3):e361-39. DOI:10.1016/j.cgh.2021.03.034
4. Balderramo D. Role of the combination of biologics and/or small molecules in the treatment of patients with inflammatory bowel disease. World J Gastroenterol. 2022;28(47):6743-71. DOI:10.3748/wjg.v28.i47.6743
5. Mas EB, Calvo XC. Selecting the Best Combined Biological Therapy for Refractory Inflammatory Bowel Disease Patients. J Clin Med. 2022;11(4):1076. DOI:10.3390/jcm11041076
6. Privitera G, Onali S, Pugliese D, et al. Dual Targeted Therapy: a possible option for the management of refractory Inflammatory Bowel Disease. J Crohns Colitis. 2020;jjaa149. DOI:10.1093/ecco-jcc/jjaa149
7. Glassner K, Oglat A, Duran A, et al. The use of combination biological or small molecule therapy in inflammatory bowel disease: A retrospective cohort study. J Dig Dis. 2020;21(5):264-71. DOI:10.1111/1751-2980.12867
8. Kwapisz L, Raffals LE, Bruining DH, et al. Combination Biologic Therapy in Inflammatory Bowel Disease: Experience From a Tertiary Care Center. Clin Gastroenterol Hepatol. 2021;19(3):616-1. DOI:10.1016/j.cgh.2020.02.017
9. Sands BE, Kozarek R, Spainhour J, et al. Safety and tolerability of concurrent natalizumab treatment for patients with Crohn's disease not in remission while receiving infliximab. Inflamm Bowel Dis. 2007;13(1):2-11. DOI:10.1002/ibd.20014
10. Yang E, Panaccione N, Whitmire N, et al. Efficacy and safety of simultaneous treatment with two biologic medications in refractory Crohn's disease. Aliment Pharmacol Ther. 2020;51(11):1031-8. DOI:10.1111/apt.15719
11. Honap S, Netter P, Danese S, Peyrin-Biroulet L. An update on the safety of long-term vedolizumab use in inflammatory bowel disease. Expert Opin Drug Saf. 2023;22(9):767-76. DOI:10.1080/14740338.2023.2247976
12. Avedillo-Salas A, Corral-Cativiela S, Fanlo-Villacampa A, Vicente-Romero J. The Efficacy and Safety of Biologic Drugs in the Treatment of Moderate-Severe Crohn's Disease: A Systematic Review. Pharmaceuticals (Basel). 2023;16(11):1581. DOI:10.3390/ph16111581
13. Miyatani Y, Choi D, Choi NK, Rubin DT. Dual-Targeted Therapy with Upadacitinib and Ustekinumab in Medically Complex Crohn's Disease. Dig Dis Sci. 2024;69(2):355-5. DOI:10.1007/s10620-023-08182-y
14. Harvey Bradshaw Index for Crohn’s disease calculator. Available at: https://www.thecalculator.co/health/Harvey-Bradshaw-Index-For-Crohn%E2%80%99s-Disease-Calculator-103.... Accessed: 25.04.2025.
15. Daperno M, D'Haens G, Van Assche G, et al. Development and validation of a new, simplified endoscopic activity score for Crohn's disease: the SES-CD. Gastrointest Endosc. 2004;60(4):505-12. DOI:10.1016/s0016-5107(04)01878-4
2. Haider M, Lashner B. Dual Targeted Therapy for the Management of Inflammatory Bowel Disease. J Clin Gastroenterol. 2021;55(8):661-6. DOI:10.1097/MCG.0000000000001583
3. Ahmed W, Galati J, Kumar A, et al. Dual Biologic or Small Molecule Therapy for Treatment of Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2022;20(3):e361-39. DOI:10.1016/j.cgh.2021.03.034
4. Balderramo D. Role of the combination of biologics and/or small molecules in the treatment of patients with inflammatory bowel disease. World J Gastroenterol. 2022;28(47):6743-71. DOI:10.3748/wjg.v28.i47.6743
5. Mas EB, Calvo XC. Selecting the Best Combined Biological Therapy for Refractory Inflammatory Bowel Disease Patients. J Clin Med. 2022;11(4):1076. DOI:10.3390/jcm11041076
6. Privitera G, Onali S, Pugliese D, et al. Dual Targeted Therapy: a possible option for the management of refractory Inflammatory Bowel Disease. J Crohns Colitis. 2020;jjaa149. DOI:10.1093/ecco-jcc/jjaa149
7. Glassner K, Oglat A, Duran A, et al. The use of combination biological or small molecule therapy in inflammatory bowel disease: A retrospective cohort study. J Dig Dis. 2020;21(5):264-71. DOI:10.1111/1751-2980.12867
8. Kwapisz L, Raffals LE, Bruining DH, et al. Combination Biologic Therapy in Inflammatory Bowel Disease: Experience From a Tertiary Care Center. Clin Gastroenterol Hepatol. 2021;19(3):616-1. DOI:10.1016/j.cgh.2020.02.017
9. Sands BE, Kozarek R, Spainhour J, et al. Safety and tolerability of concurrent natalizumab treatment for patients with Crohn's disease not in remission while receiving infliximab. Inflamm Bowel Dis. 2007;13(1):2-11. DOI:10.1002/ibd.20014
10. Yang E, Panaccione N, Whitmire N, et al. Efficacy and safety of simultaneous treatment with two biologic medications in refractory Crohn's disease. Aliment Pharmacol Ther. 2020;51(11):1031-8. DOI:10.1111/apt.15719
11. Honap S, Netter P, Danese S, Peyrin-Biroulet L. An update on the safety of long-term vedolizumab use in inflammatory bowel disease. Expert Opin Drug Saf. 2023;22(9):767-76. DOI:10.1080/14740338.2023.2247976
12. Avedillo-Salas A, Corral-Cativiela S, Fanlo-Villacampa A, Vicente-Romero J. The Efficacy and Safety of Biologic Drugs in the Treatment of Moderate-Severe Crohn's Disease: A Systematic Review. Pharmaceuticals (Basel). 2023;16(11):1581. DOI:10.3390/ph16111581
13. Miyatani Y, Choi D, Choi NK, Rubin DT. Dual-Targeted Therapy with Upadacitinib and Ustekinumab in Medically Complex Crohn's Disease. Dig Dis Sci. 2024;69(2):355-5. DOI:10.1007/s10620-023-08182-y
14. Harvey Bradshaw Index for Crohn’s disease calculator. Available at: https://www.thecalculator.co/health/Harvey-Bradshaw-Index-For-Crohn%E2%80%99s-Disease-Calculator-103.... Accessed: 25.04.2025.
15. Daperno M, D'Haens G, Van Assche G, et al. Development and validation of a new, simplified endoscopic activity score for Crohn's disease: the SES-CD. Gastrointest Endosc. 2004;60(4):505-12. DOI:10.1016/s0016-5107(04)01878-4
________________________________________________
2. Haider M, Lashner B. Dual Targeted Therapy for the Management of Inflammatory Bowel Disease. J Clin Gastroenterol. 2021;55(8):661-6. DOI:10.1097/MCG.0000000000001583
3. Ahmed W, Galati J, Kumar A, et al. Dual Biologic or Small Molecule Therapy for Treatment of Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2022;20(3):e361-39. DOI:10.1016/j.cgh.2021.03.034
4. Balderramo D. Role of the combination of biologics and/or small molecules in the treatment of patients with inflammatory bowel disease. World J Gastroenterol. 2022;28(47):6743-71. DOI:10.3748/wjg.v28.i47.6743
5. Mas EB, Calvo XC. Selecting the Best Combined Biological Therapy for Refractory Inflammatory Bowel Disease Patients. J Clin Med. 2022;11(4):1076. DOI:10.3390/jcm11041076
6. Privitera G, Onali S, Pugliese D, et al. Dual Targeted Therapy: a possible option for the management of refractory Inflammatory Bowel Disease. J Crohns Colitis. 2020;jjaa149. DOI:10.1093/ecco-jcc/jjaa149
7. Glassner K, Oglat A, Duran A, et al. The use of combination biological or small molecule therapy in inflammatory bowel disease: A retrospective cohort study. J Dig Dis. 2020;21(5):264-71. DOI:10.1111/1751-2980.12867
8. Kwapisz L, Raffals LE, Bruining DH, et al. Combination Biologic Therapy in Inflammatory Bowel Disease: Experience From a Tertiary Care Center. Clin Gastroenterol Hepatol. 2021;19(3):616-1. DOI:10.1016/j.cgh.2020.02.017
9. Sands BE, Kozarek R, Spainhour J, et al. Safety and tolerability of concurrent natalizumab treatment for patients with Crohn's disease not in remission while receiving infliximab. Inflamm Bowel Dis. 2007;13(1):2-11. DOI:10.1002/ibd.20014
10. Yang E, Panaccione N, Whitmire N, et al. Efficacy and safety of simultaneous treatment with two biologic medications in refractory Crohn's disease. Aliment Pharmacol Ther. 2020;51(11):1031-8. DOI:10.1111/apt.15719
11. Honap S, Netter P, Danese S, Peyrin-Biroulet L. An update on the safety of long-term vedolizumab use in inflammatory bowel disease. Expert Opin Drug Saf. 2023;22(9):767-76. DOI:10.1080/14740338.2023.2247976
12. Avedillo-Salas A, Corral-Cativiela S, Fanlo-Villacampa A, Vicente-Romero J. The Efficacy and Safety of Biologic Drugs in the Treatment of Moderate-Severe Crohn's Disease: A Systematic Review. Pharmaceuticals (Basel). 2023;16(11):1581. DOI:10.3390/ph16111581
13. Miyatani Y, Choi D, Choi NK, Rubin DT. Dual-Targeted Therapy with Upadacitinib and Ustekinumab in Medically Complex Crohn's Disease. Dig Dis Sci. 2024;69(2):355-5. DOI:10.1007/s10620-023-08182-y
14. Harvey Bradshaw Index for Crohn’s disease calculator. Available at: https://www.thecalculator.co/health/Harvey-Bradshaw-Index-For-Crohn%E2%80%99s-Disease-Calculator-103.... Accessed: 25.04.2025.
15. Daperno M, D'Haens G, Van Assche G, et al. Development and validation of a new, simplified endoscopic activity score for Crohn's disease: the SES-CD. Gastrointest Endosc. 2004;60(4):505-12. DOI:10.1016/s0016-5107(04)01878-4
Авторы
О.В. Князев*1, А.В. Каграманова1,2, А.А. Лищинская1, Е.А. Сабельникова1,3, Н.В. Лазука1, А.И. Парфенов1
1ГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы, Москва, Россия;
2ГБУ г. Москвы «Научно-исследовательский институт организации здравоохранения и медицинского менеджмента» Департамента здравоохранения г. Москвы, Москва, Россия;
3ФГБОУ ВО «Российский университет медицины» Минздрава России, Москва, Россия
*o.knyazev@mknc.ru
1Loginov Moscow Clinical Scientific Center, Moscow, Russia;
2Research Institute for Healthcare Organization and Medical Management, Moscow, Russia;
3Russian University of Medicine, Moscow, Russia
*o.knyazev@mknc.ru
1ГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы, Москва, Россия;
2ГБУ г. Москвы «Научно-исследовательский институт организации здравоохранения и медицинского менеджмента» Департамента здравоохранения г. Москвы, Москва, Россия;
3ФГБОУ ВО «Российский университет медицины» Минздрава России, Москва, Россия
*o.knyazev@mknc.ru
________________________________________________
1Loginov Moscow Clinical Scientific Center, Moscow, Russia;
2Research Institute for Healthcare Organization and Medical Management, Moscow, Russia;
3Russian University of Medicine, Moscow, Russia
*o.knyazev@mknc.ru
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