20.500.12556/DiRROS-25351 Reaching the therapeutic ceiling in IBD can Advanced Combination Treatment (ACT) offer a solution? The term Advanced Combination Treatment (ACT) involves the combination of at least two biologics or the use of a biologic with a small molecule drug, each with different mechanisms of action. This narrative review evaluates the current evidence supporting ACT in inflammatory bowel disease (IBD), focusing on preclinical studies, real-world evidence, and randomized controlled trials. A systematic review of randomized controlled trials has concluded that ACT significantly improves clinical outcomes, without significant safety concerns in patient with IBD. However, variability in trial designs and the lack of standardized outcome measures have led to initiatives aimed at mitigating these issues through a clear expert consensus. While the evidence for ACT in IBD is compelling, substantial challenges remain in standardizing treatment protocols and ensuring long-term safety. In the meantime, the use of ACT in clinical practice remains off-label and requires careful consideration of patient-specific factors. Future clinical trials should consider robust biomarkers for patient selection and leverage mechanistic insights to select combination components. immune-mediated inflammatory diseases therapeutic ceiling Crohn's diseaseulcerative colitis true false true Angleški jezik Ni določen Neznano 2026-01-16 14:09:38 2026-01-16 14:09:39 2026-01-17 04:06:10 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 14. 1. 2025; str. 1-7 [article no.] 101981 Vol. 77 Avg. 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 61 1532-1916 10.1016/j.bpg.2025.101981 222265859 RAZ_Solitano_Virginia_2025.pdf RAZ_Solitano_Virginia_2025.pdf 1 15F835AAE22FEA3AD39B81C2DFB82481 01ffb70cc80b31a3c4ae392e358e017425d2be21e3db89a300b407b299dbb481 fc177ddb-f2dc-11f0-a15d-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=38360 https://doi.org/10.1016/j.bpg.2025.101981 1 9ff21cb4-f2dc-11f0-a15d-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=38359 Univerzitetni klinični center Ljubljana 0 0 0