Research Communication: Combination Therapy of Upadacitinib With Infliximab, Risankizumab, Ustekinumab or Vedolizumab for Refractory Crohn's Disease: A Descriptive Case Series

Combining two advanced therapies may improve outcomes in Crohn's disease (CD) refractory to monotherapy. We conducted a descriptive case series of 27 patients with CD who initiated combination therapy with upadacitinib and infliximab (n = 1), risankizumab (n = 17), ustekinumab (n = 3) or vedolizumab (n = 6). At 12 weeks, 24 achieved clinical response and 9 achieved steroid-free remission. At 52 weeks, these rates were 15/20 and 11/20, respectively. Endoscopic response and extraintestinal manifestation improvement were frequently observed. Adverse events occurred in 13 patients, leading to treatment discontinuation in three. Combining upadacitinib with a biologic appeared effective and safe, warranting further investigation in prospective studies.