A few weeks (months?) ago there was some discussion here about
whether a person can take multiple biologic medications simultaneously (such as an anti-TNF plus Entyvio or Stelara).
Somebody shared a couple of small studies showing it has been done.
The topic actually came up at the most recent conference I attended (which saved me from having to ask).
The doctor said that while there isn't enough actual study data to make solid recommendations, there are a few IBD centers across the country that have put select patients on two biologics at the same time.
They do this only for highest-risk patients, generally those who can't tolerate immunomodulators (methotrexate, aza, 6mp), have severe disease, and have already had multiple surgeries and can't have another one without excessive risk.
The risks of serious infection while on two biologics are not well characterized because of the lack of studies, so the patients are watched closely.
So it is an option for a limited number of select patients at a few select
locations around the US, but the risks vs benefits aren't well-characterized by large studies.
It's not approved by the FDA, and insurance will likely not like covering the costs involved, so it would take a considerable amount of work for the GI to get insurance to approve. But some GIs have been successful in getting approval.
Post Edited (beave) : 9/9/2018 6:50:26 PM (GMT-6)