Risks of therapeutic combinations

Therapeutic combinations in the management of patients with IBD are increasingly used, either for their effectiveness on digestive damage, or to treat an associated rheumatic disease or extra-digestive manifestations. However, these combinations of treatments are often associated with an increased risk of infection or cancer. Thus, the combotherapy of an anti-TNF and a thiopurine is associated with an increased risk of severe infections and an increased risk of lymphomas compared to the use of an anti-TNF or a thiopurine monotherapy. The combotherapy of vedolizumab or ustekinumab and a thiopurine is not associated with an increased risk of severe infections or cancer. The paucity of long-term data concerning combination therapies and the heterogeneity of treatment combinations do not make it possible to analyze the increased risk of infection or carcinology.