[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-406366-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-406366-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","dual-biologic-therapy-in-patient-with-refractory-ulcerative-colitis-and-comorbidities-a-case-report","Dual biologic therapy in patient with refractory ulcerative colitis and comorbidities - A case report","","Despite therapeutic advances in ulcerative colitis (UC), some patients remain refractory to available options. Dual biologic therapy (DBT) has been proposed for such difficult cases. This report describes an individual with extensive UC, steroid dependence, and comorbidities including prior breast cancer and myocardial infarction, with treatment limited by contraindications to tumor necrosis factor and Janus kinase inhibitors. Vedolizumab plus mirikizumab achieved sustained clinical and biochemical remission without recorded adverse events during follow-up.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/dual-biologic-therapy-in-patient-with-refractory-ulcerative-colitis-and-comorbidities-a-case-report/406366/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/dual-biologic-therapy-in-patient-with-refractory-ulcerative-colitis-and-comorbidities-a-case-report/406366.png","ImageObject",300,407,{"name":42,"@type":43},"Chumphorn","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-06","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What patient factors made treatment with TNF and JAK inhibitors unsuitable?","Question",{"text":63,"@type":64},"The case involved extensive UC with steroid dependence and contraindications based on past medical history, including breast cancer and prior myocardial infarction, limiting TNF and JAK inhibitor use.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which dual biologic regimen was used in this case?",{"text":68,"@type":64},"The patient received DBT with vedolizumab (α4β7 integrin antagonist) combined with mirikizumab (interleukin-23p19 inhibitor).",{"name":70,"@type":61,"acceptedAnswer":71},"What outcomes were reported after DBT?",{"text":72,"@type":64},"The combination therapy led to sustained clinical and biochemical remission, and no adverse events were recorded during the follow-up period.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},406366,1790899737,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":102,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},2336475401981,"https://ap-avatar.wpscdn.com/avatar/22000c94efd8d5204d?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786935347598174694","| W | J | G | World Journal of\u003Cbr>Gastroenterology |\n| --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastroenterol 2025 December 21; 31(47): 113381  \nDOI: 10.3748/wjg.v31.i47.113381 ISSN 1007-9327 (print) ISSN 2219-2840 (online)  \nCASE REPORT  \nDual biologic therapy in patient with refractory ulcerative colitis and comorbidities: A case report  \nAndreia C Guimarães, Rocio Ferreiro-Iglesias, Cristina Calviño-Suarez, Iria Baston-Rey, Manuel Barreiro-de Acosta  \nSpecialty type: Gastroenterology and hepatology  \nProvenance and peer review:  \nUnsolicited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade B, Grade B, Grade B  \nNovelty: Grade A, Grade A, Grade A  \nCreativity or Innovation: Grade A, Grade A, Grade A  \nScientific Significance: Grade B, Grade B, Grade B  \nP-Reviewer: Fuentes-Valenzuela E, MD, Academic Fellow, Spain; Loktionov A, MD, PhD, Director, United Kingdom  \nReceived: August 25, 2025  \nRevised: September 27, 2025  \nAccepted: November 4, 2025  \nPublished online: December 21, 2025  \nProcessing time: 118 Days and 10.3 Hours  \nAndreia C Guimarães, Department of Gastroenterology, Local Health Unit of Braga, Braga 4710-243, Portugal  \nRocio Ferreiro-Iglesias, Cristina Calviño-Suarez, Iria Baston-Rey, Manuel Barreiro-de Acosta,  \nDepartment of Gastroenterology, University Hospital Santiago de Compostela, Santiago de Compostela 15706, Galicia, Spain  \nRocio Ferreiro-Iglesias, Cristina Calviño-Suarez, Iria Baston-Rey, Manuel Barreiro-de Acosta,  \nFundación Pública Galega, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela 15706, Galicia, Spain  \nCorresponding author: Andreia C Guimarães, MD, Department of Gastroenterology, Local Health Unit of Braga, Sete Fontes, Sao Victor, Braga 4710-243, Portugal.  \n[andreiaguimaraes32@gmail.com](andreiaguimaraes32@gmail.com)  \nAbstract  \nBACKGROUND  \nDespite advances in the treatment of ulcerative colitis (UC), some patients remain refractory to the currently available treatments. Dual biologic therapy (DBT) has emerged as a promising strategy for these patients.  \nCASE SUMMARY  \nA patient with extensive UC presented with steroid dependence and contraindications (past medical history included breast cancer and previous myocardial infarction) to treatment with tumor necrosis factor and Janus kinase inhibitors. DBT of α4β7 integrin antagonist (vedolizumab) and interleukin 23p19 inhibitor (mirikizumab) resulted in a sustained clinical and biochemical remission. No adverse events were recorded during the follow-up.  \nCONCLUSION  \nThis case highlighted the challenge of managing refractory UC, especially in frail patients.  \nKey Words: Inflammatory bowel disease; Refractory ulcerative colitis; Combination therapy; Mirikizumab; Vedolizumab; Case report  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \n WJG  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 21, 2025  Volume 31  Issue 47   \nGuimarães AC et al. DBT in UC treatment  \nCore Tip: Dual biologic therapy (DBT) is a promising treatment option for patients with refractory ulcerative colitis (UC) who have limited therapeutic alternatives. We presented the first case of a patient with extensive UC treated with mirikizumab and vedolizumab due to contraindications to tumor necrosis factor and Janus kinase inhibitors. The combination of mirikizumab and vedolizumab led to sustained clinical and biochemical remission without adverse events. Our case highlighted the therapeutic potential and safety of DBT in selected patients, reinforcing the need for individualized treatment strategies in complex clinical scenarios.  \nCitation: Guimarães AC, Ferreiro-Iglesias R, Calviño-Suarez C, Baston-Rey I, Barreiro-de Acosta M. Dual biologic therapy in patient  \nwith refractory ulcerative colitis and comorbidities: A case ","cbCaiiKyp74GwlPm","https://ap.wps.com/l/cbCaiiKyp74GwlPm","pdf",603764,"English","# Case report\n## Abstract\n## Background\n## Case summary\n## Conclusion\n## Introduction\n## Chief complaints\n## History of present illness","[{\"question\":\"What patient factors made treatment with TNF and JAK inhibitors unsuitable?\",\"answer\":\"The case involved extensive UC with steroid dependence and contraindications based on past medical history, including breast cancer and prior myocardial infarction, limiting TNF and JAK inhibitor use.\"},{\"question\":\"Which dual biologic regimen was used in this case?\",\"answer\":\"The patient received DBT with vedolizumab (α4β7 integrin antagonist) combined with mirikizumab (interleukin-23p19 inhibitor).\"},{\"question\":\"What outcomes were reported after DBT?\",\"answer\":\"The combination therapy led to sustained clinical and biochemical remission, and no adverse events were recorded during the follow-up period.\"}]","Dual biologic therapy in patient with refractory ulcerative colitis and comorbidities - A case report | PDF",1790565138,15]