One of the most important studies of the past few years for dermatologists involved patients with ulcerative colitis, according to Arthur Kavanaugh, MD.
'Combination Is Back,' Doctor Declares at Maui Derm
02/21/2025
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One of the most important studies of the past few years for dermatologists involved patients with ulcerative colitis, according to Arthur Kavanaugh, MD.
Dr. Kavanaugh made that case during the panel presentation “Psoriasis Update 2025” at Maui Derm 2025 in Maui, Hawaii.
Noting that his fellow rheumatologists ruined combination therapies for a period of time with some bad outcomes that resulted in black box warnings, Dr. Kavanaugh said that treatment strategy is making a comeback, thanks in part to a 2023 study on the combination of guselkumab and golimumab.1
“Patients with ulcerative colitis … were randomized with the TNF inhibitor golumimab and the [IL]-23 inhibitor guselkumab in combination,” Dr. Kavanaugh said. “At week 12, they went to monotherapy, so the combination therapy was for 12 weeks, just to get through. Responses were absolutely fantastic. … Most importantly, adverse events were not increased.”
The implications could be wide-ranging for other potential combination therapies.
“This is the dream from the late ’80s, based on animal studies: that you could combine biologic agents with different mechanisms of action and get better efficacy and not more toxicity,” Dr. Kavanaugh said. “Combination, I think, is back, and it’s not a question of, ‘Could we do it?’ It’s, ‘For which combinations does this make sense where we can see additional benefit and not see additional [adverse events]?’”
- Feagan BG, et al; VEGA Study Group. Guselkumab plus golimumab combination therapy versus guselkumab or golimumab monotherapy in patients with ulcerative colitis (VEGA): a randomised, double-blind, controlled, phase 2, proof-of-concept trial. Lancet Gastroenterol Hepatol. 2023;8(4):307-320. doi: 10.1016/S2468-1253(22)00427-7. Epub 2023 Feb 1.
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