title: Risks and benefits of combining immunosuppressives and biological agents in inflammatory bowel disease: is the synergy worth the risk?
abstract: Since the introduction of infliximab to treat Crohn's disease, combination therapy with immunosuppressants has reduced immunogenicity, without impacting efficacy. The availability of novel anti-TNF agents and potential combined toxicities question the risk/benefit of combination therapies.
authors: Department of Medicine and Clinical Pharmacology, University of Chicago Hospital, 5841 S. Maryland Ave., MC 4076, Chicago, IL 60637, USA. shanauer@uchicago.edu
authors: Stephen B
authors: SB
authors: Hanauer
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000276:immunology; D003424:Crohn Disease / Q000188:drug therapy / Q000276:immunology; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000276:immunology; D000069285:Infliximab; D018570:Risk Assessment; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab
references: Gastroenterology. 2007 Jan;132(1):52-65
references: 17241859
references: Cancer Epidemiol Biomarkers Prev. 2006 Nov;15(11):2069-77
references: 17119030
references: J Pediatr Gastroenterol Nutr. 2007 Feb;44(2):265-7
references: 17255842
references: Gut. 2007 Sep;56(9):1226-31
references: 17229796
references: Am J Gastroenterol. 2000 Dec;95(12):3469-77
references: 11151879
references: Gastroenterology. 2002 Jan;122(1):72-7
references: 11781282
references: Lancet. 2002 May 4;359(9317):1541-9
references: 12047962
references: Am J Gastroenterol. 2002 Dec;97(12):2962-72
references: 12492177
references: Toxicology. 2003 Apr 1;185(3):229-40
references: 12581698
references: N Engl J Med. 2003 Feb 13;348(7):601-8
references: 12584368
references: Gastroenterology. 2003 Apr;124(4):917-24
references: 12671888
references: Gastroenterology. 2003 Apr;124(4):1140-5
references: 12671907
references: Leuk Lymphoma. 2003 Mar;44(3):531-3
references: 12688327
references: Gastroenterology. 2004 Feb;126(2):402-13
references: 14762776
references: Drug Saf. 2004;27(5):307-24
references: 15061685
references: Gastroenterology. 2004 May;126(6):1593-610
references: 15168370
references: Clin Gastroenterol Hepatol. 2004 Jul;2(7):542-53
references: 15224278
references: Am J Gastroenterol. 2004 Oct;99(10):1984-9
references: 15447761
references: N Engl J Med. 1997 Oct 9;337(15):1029-35
references: 9321530
references: Gastroenterology. 1999 Oct;117(4):761-9
references: 10500056
references: Am J Gastroenterol. 2005 Jan;100(1):75-9
references: 15654784
references: J Pediatr Gastroenterol Nutr. 2007 Feb;44(2):165-7
references: 17255825
references: Gastroenterology. 2005 Apr;128(4):862-9
references: 15825070
references: Semin Arthritis Rheum. 2005 Apr;34(5 Suppl1):19-22
references: 15852250
references: Gut. 2005 Aug;54(8):1121-5
references: 16009685
references: N Engl J Med. 2005 Jul 28;353(4):362-8
references: 15947080
references: Gastroenterology. 2005 Sep;129(3):807-18
references: 16143120
references: N Engl J Med. 2005 Nov 3;353(18):1912-25
references: 16267322
references: Am J Epidemiol. 2005 Dec 15;162(12):1153-61
references: 16251389
references: Aliment Pharmacol Ther. 2006 Feb 15;23(4):451-63
references: 16441465
references: Gastrointest Endosc. 2006 Mar;63(3):433-42; quiz 464
references: 16500392
references: Gastroenterology. 2006 Mar;130(3):650-6
references: 16530505
references: Gastroenterology. 2006 Mar;130(3):940-87
references: 16530532
references: Gastroenterology. 2006 Apr;130(4):1054-61
references: 16618399
references: Clin Gastroenterol Hepatol. 2006 May;4(5):621-30
references: 16678077
references: Ann Rheum Dis. 2006 Jun;65(6):746-52
references: 16339288
references: Ann Rheum Dis. 2006 Jun;65(6):701-3
references: 16699049
references: Curr Opin Gastroenterol. 2006 Jul;22(4):370-6
references: 16760752
references: Aliment Pharmacol Ther. 2006 Jul 15;24(2):331-42
references: 16842460
references: Aliment Pharmacol Ther. 2006 Sep 1;24(5):715-29
references: 16918876
references: Rheumatology (Oxford). 2006 Sep;45(9):1121-4
references: 16510526