More than 4.9 million people worldwide are thought to suffer from inflammatory bowel disease (IBD), which is a catch-all name for ulcerative colitis (UC) and Crohn’s disease, two disorders that adversely affect the digestive tract.
IBD presently has no known cure. The goal of current treatments is to achieve remission by reducing inflammation and relieving symptoms by medication, lifestyle modifications, and surgery.
Regretfully, not every IBD patient responds to every drug. According to earlier research, one-third to one-half of IBD patients do not improve with any kind of treatment.
According to two recent studies that were presented at Digestive Disease Week® (DDW) 2026, treating IBD with a combination of two drugs may be more effective than using each medication alone, particularly in patients who had previously not responded to other regimens.
Two concurrent clinical trials examine two drugs
Researchers investigated the use of a combination fixed-dose co-antibody therapy known as JNJ-4804, which combined the drugs anti-IL-23 therapy guselkumab and anti-TNF antibodyTrusted Source golimumab. These two Phase 2b clinical trials, DUET-Crohn’s and DUET-UC, were sponsored by Johnson & Johnson.
Bruce E. Sands, MD, MS, Dr. Burrill B. Crohn Professor of Medicine at the Icahn School of Medicine, chief of the Dr. Henry D. Janowitz Division of Gastroenterology at Mount Sinai Health System, and lead author of the Crohn’s disease study, told Medical News Today, “We have seen an explosion of new kinds of treatments to treat IBD over the last 25 years.”
Unfortunately, despite the fact that many of these medications are very effective, their effectiveness is gradually plateauing. We must continue to develop new treatments that are safer, more effective, and ideally more long-lasting,” he stated.
Maria T. Abreu, MD, executive director of the F. Widjaja IBD Institute at Cedars-Sinai and lead author of the ulcerative colitis study, stated, “It is important that the study only allowed patients to come into the study that had already been on [at] least one previous advanced systemic therapeutic mechanism.” For instance, they may have previously used anti-TNF, anti-IL-23, or a combination of these medications.
“Treating patients who have been on nothing is usually the low hanging fruit,” Abreu told MNT. “The possibilities are endless if they have been on nothing. For those who have been on nothing, most things are beneficial. However, individuals who have previously taken drugs that either lost their effectiveness, lost their charm, or had no impact at all are more resistant to treatment.
According to her, “it is actually feasible that the immune system alters because now if you suppress one component, the immune system attempts to find a method to sustain this inflammatory response.” “Therefore, they were basically requesting that patients who were the hardest to treat be included.”
For the Crohn’s study, 693 people were enlisted, and for the UC trial, 572. Participants were randomly assigned to receive the combination therapy JNJ-4804, golimumab alone, guselkumab alone, or a placebo.
At the end of the UC clinical trial, researchers found that JNJ-4804 demonstrated similar efficacy to guselkumab across important measures of remission and endoscopic improvement at 48 weeks, as well as better results when compared to golimumab for study participants who had previously tried and failed one or more therapies. The maximum dosage of JNJ-4804 fared better in the CD study than any of the two individual medications.
“It makes a lot of sense that we are going to be employing combinations of therapy for patients who have failed two or more modes of action, which we are receiving more and more as we extend our armamentarium,” Abreu said.
“Ideally, they will be logical, which means that the treatments will have some thought and complimentary methods of action. And employing this combo is actually the first step in that direction. Therefore, I believe we will be saving our combo therapies for the patients who are most in need, at least for the time being,” she stated.