Advancing the Science of Concurrent Biologic Therapy
Prospective data on combining biologics remain scarce. The registry aggregates real-world outcomes from published literature and de-identified clinical submissions worldwide, so decisions made one case at a time can draw on the whole record.
Combination Matrix
September 2026
Combination matrix of the 6 most reported biologics in the registry. The most reported pair is Dupilumab plus Omalizumab with 51 patient cases.
Most reported: Dupilumab + Omalizumab (51 cases)
Six most reported biologics shown. Empty cells are combinations awaiting evidence.
Explore the full matrix178
Patient Cases
52
Combinations
60
Diagnoses
85%
Positive Outcomes
The Problem
A Critical Gap in the Evidence Base
Concurrent biologic use is an increasingly common clinical consideration, yet the data needed to guide it remain scattered.
There is no shared record of how concurrent biologic therapy performs across specialties. Clinicians decide one case at a time, on partial information.
In the clinic
Concurrent therapy is a growing consideration
- Patients with overlapping immune-mediated conditions
- Disease refractory to single-agent therapy
- Decisions spanning gastroenterology, rheumatology, and dermatology
In the literature
The evidence base has not kept pace
- Isolated case reports and small case series
- Extrapolation from single-agent data
- No aggregated record of safety, efficacy, or interactions
The Solution
The First Registry for Concurrent Biologic Therapy
A centralized, curated repository bridging clinical practice and real-world evidence across immune-mediated inflammatory diseases.
Centralized evidence
Cases that would otherwise stay isolated in single publications, or go unreported, are gathered where patterns can be recognized.
Multi-center, international
Published literature and clinical submissions from diverse sites worldwide, reflecting the complexity of real patient populations.
Toward consensus
As the record grows, aggregated data can inform consensus recommendations for concurrent prescribing across specialties.
Isolated case reports and unreported clinical experience are consolidated into one structured registry.
How It Works
A Dual-Source Evidence Model
Published evidence and unpublished clinical experience enter through two complementary pathways and pass a single quality gate.
Published literature
Case reports, case series, and observational studies, extracted into a standardized format.
Clinical submissions
De-identified cases submitted by healthcare professionals through a structured template.
Submit a caseQuality review
Every case is checked for completeness, clinical plausibility, and consistency before inclusion.
One open record
Aggregated, searchable, and freely accessible to clinicians worldwide.
Clinical scope
What each case records
The registry accepts cases across immune-mediated inflammatory diseases and records the same de-identified variables for each one.
Inclusion criterion
One biologic plus a second biologic or a targeted oral therapy makes one registry case.
At least two concurrent advanced therapies, at least one of which is a biologic. Conventional systemic immunosuppressants are recorded separately as concomitant therapy.
Recorded for every case
Demographics
Age bracket and sex
Agents prescribed
Biologics and targeted oral therapies
Primary diagnosis
Coded to ICD-10
Duration
Length of concurrent therapy
Concomitant medications
Conventional systemic agents
Disease activity
Validated measures, where available
Clinical outcome
On a standardized scale
Adverse events
Observed during treatment
No personally identifiable health information is collected at any stage.
Conditions
Immune-mediated inflammatory diseases across specialties.
Biologics
Any biologic agent, recorded by class or individual molecule.
Targeted oral therapies
Targeted synthetic agents and oral targeted peptides, recorded alongside biologics.
By the Numbers
Registry at a Glance
Real-world evidence from concurrent biologic therapy across published literature and clinical submissions.
178 patient cases from 56 peer-reviewed sources and clinician submissions worldwide. Data current as of September 2026.
Patient Cases
From peer-reviewed literature and clinician submissions
Unique Combinations
43 biologic pairs, 9 biologic + oral
Positive Outcomes
Of 162 classified outcomes
Adverse Events Reported
25 of 159 cases with reported status
Concomitant Systemic Therapy
34 of 178 cases
Drug Combinations
Therapy Combination Explorer
Patient-level outcome data can be viewed by selecting any combination: biologic pairs by molecule or by drug class, biologic plus targeted oral therapy combinations, or the ranked list of every combination.
Filter the data
Showing 178 of 178 cases.
Diagnosis
Region
Combination
Biologic
Oral therapy
Therapy combination patient counts
n = 152 cases across 43 biologic pairs
Patient case counts for therapy combinations, viewable as a matrix of biologic pairs by molecule or by drug class, as a matrix of biologics against targeted oral therapies, or as a ranked list of every combination. Selecting a populated cell or list entry opens a case-level table below.
Showing 18 of 26 biologics, those with two or more cases.
26 biologic + targeted oral therapy cases shown separately.
Cohort Composition
Registry Coverage
Where cases are contributed from and which disease combinations drive concurrent biologic therapy.
Geographic distribution
n = 178
Cases contributed across 5 continents. Selecting a bar filters the data sections by region.
Diagnosis landscape
n = 178
Groups are not mutually exclusive; a case may carry several diagnoses. Selecting a bar filters the data sections by diagnosis.
Clinical Outcomes
Treatment Response and Demographics
Outcome categorization and demographic distribution across the registry cohort.
Outcome category
n = 178
- Complete Remission (18)
- Well Controlled (52)
- Improvement (67)
- Mixed (18)
- No Response (7)
- Not Reported (16)
Age distribution
n = 178
Sex was not recorded for 18 cases, shown in slate.
Treatment Patterns
Duration and Prescribing Trends
Duration of concurrent therapy and prescribing frequency across the cohort.
Treatment duration
n = 178
18 cases without reported duration, shown in slate.
Most prescribed agents
n = 178 cases, two agents each
Safety Data
Adverse Event Profile
Reported adverse events by therapy combination and by sex. All reported events are captured regardless of severity or attribution.
Adverse events by combination
n = 178
All reported events are shown regardless of severity or attribution; no inference of causality is implied. Combinations with fewer than 10 cases are pooled. 19 cases from series reporting adverse events only at cohort level are shown in slate and excluded from rates.
Adverse events by sex
n = 160 of 178 with recorded sex
19 cases from series reporting adverse events only at cohort level, shown in slate.
Independent and open access
No industry funding. No paywalls.
The Concurrent Biologics Registry is provided free of charge to clinicians worldwide and operates without pharmaceutical industry funding or compensation.
- Open access
- Independent
- No industry funding
Disclosure statement
Applies to all content
- Access to data and visualizationsNo registration, login, or payment required
- Free
- Pharmaceutical industry fundingNo drug manufacturer supports this work
- None
- Sponsorship or compensationNo payment from manufacturers or trade groups
- None
- Industry influence on scope, methodology, or contentEditorial decisions are made independently
- None
Trust and transparency
Built on rigor, designed for openness
A freely accessible quality assurance and practice improvement resource that consolidates published and clinician-submitted evidence into a single repository.
De-identified by design
Only aggregate clinical variables are captured: age band, sex, disease category, agents, and outcomes.
Never collected
- No names
- No dates of birth
- No treatment dates
- No record numbers
Open-access data
The full registry and every visualization are available to anyone, at the point of care.
Access requirements
- No registration
- No login
- No payment
Structured quality review
Every case is reviewed before inclusion so the data stay accurate and clinically credible.
Checked for
- Completeness
- Clinical plausibility
- Consistency
Multi-center collaboration
Cases come from published literature and de-identified submissions contributed by clinicians worldwide.
Sourced from
- Peer-reviewed literature
- Clinician submissions
- International sites
Common Questions
Frequently Asked Questions
Answers to common questions about the Concurrent Biologics Registry, its data, and how to participate.
Literature
References
56 peer-reviewed sources, 2005–2026
Response of chronic refractory psoriasis vulgaris with urticaria to combined secukinumab and omalizumab: A case report and review of the literature
Abdelmaksoud, A., Temiz, S. A., Daye, M., Yavuz, S., Wollina, U., Lotti, T., & Dursun, R.
Journal of Cosmetic Dermatology202322(4), 1416–1418
Combination treatment with monoclonal antibodies: Dupilumab and ustekinumab for the treatment of severe atopic dermatitis and Crohn disease
Alegre-Bailo, A., Sánchez-Gilo, A., Gonzalo González, I., & Vicente MartÃn, F. J.
Australasian Journal of Dermatology202465(1), 63–66
Dual biologic therapy with Omalizumab and Dupilumab for refractory atopic disease
Arasu, A., Sharma, N., Yazdabadi, A., & Sladden, M.
Australasian Journal of Dermatology202263(1), 110–111
Combined biologic therapy for the treatment of psoriasis and psoriatic arthritis: A case report
Babalola, O., Lakdawala, N., & Strober, B. E.
JAAD Case Reports20151(1), 3–4
A retrospective review of dupilumab and psoriasis biologic combination therapy
Barry, K., Zancanaro, P., Casseres, R., Dumont, N., & Rosmarin, D.
Journal of Dermatological Treatment202132(4), 438–439
Two Track Biologic Therapy for Concurrent Chronic Spontaneous Urticaria and Psoriasis Vulgaris in One Patient
Benko, M., Hrvatin Stancic, B., & Lunder, T.
Actas Dermo-Sifiliográficas2022113(10), 995–996
Landmarks for dual biological therapy in inflammatory bowel disease: lesson from two case reports of vedolizumab in combination with ustekinumab
Biscaglia, G., Piazzolla, M., Cocomazzi, F., Melchionda, G., De Cata, A., Bossa, F., Palmieri, O., & Andriulli, A.
European Journal of Gastroenterology & Hepatology202032(12), 1579–1582
Navigating the Misdiagnosis of Pityriasis Rubra Pilaris and Successful Treatment With Guselkumab: A Case Report of Dual Biologic Therapy
Bongfeldt, D., & Martinez-Cabriales, S.
Cureus202517(12), e98267
Dual biologics therapy in a patient with severe asthma and chronic urticaria: A case report and review of the literature
Bostan, O. C., Karakaya, G., Kalyoncu, A. F., & Damadoglu, E.
Journal of Asthma202461(3), 260–264
Dual biologic therapy in a patient with severe asthma and other allergic disorders
Caskey, J. R., & Kaufman, D.
BMJ Case Reports202114(5), e242211
Successful treatment of hidradenitis suppurativa in the setting of Crohn disease with combination adalimumab and ustekinumab
Cline, A., & Pichardo, R. O.
Dermatology Online Journal201925(9), Article 13030/qt0hw2w4nr
Targeted dual biologic therapy for erythroderma of unknown etiology guided by high-parameter peripheral blood immunophenotyping
Cornman, H. L., Alphonse, M. P., Dykema, A., Kollhoff, A. L., Lee, K. K., Manjunath, J., Ma, E. Z., Parthasarathy, V., Deng, J., Pritchard, T., Kambala, A., Marani, M., Parr, K. A., Mohammed, J. P., Kwatra, M. M., Bream, J. H., Ho, W. J., & Kwatra, S. G.
Scientific Reports202515(1), Article 1298
Combination Biologic Treatment of Refractory Psoriasis and Psoriatic Arthritis
Cuchacovich, R., Garcia-Valladares, I., & Espinoza, L. R.
The Journal of Rheumatology201239(1), 187–193
Omalizumab and adalimumab: a winning couple
Diluvio, L., Vollono, L., Zangrilli, A., Manfreda, V., Prete, M. D., Massaro, A., Modica, S., Greco, E., Bianchi, L., & Campione, E.
Immunotherapy202012(18), 1287–1292
Coesisting inflammatory skin diseases: Tildrakizumab to control psoriasis and omalizumab for urticaria
Diluvio, L., Pensa, C., Piccolo, A., Lanna, C., Bianchi, L., & Campione, E.
Dermatologic Therapy202235(4), e15359
The use of dual biologic therapy for the management of recalcitrant psoriasis
Finnegan, P., Murphy, M., & Bourke, J.
JAAD Case Reports202447, 93–95
Case Series: Combination of dupilumab and omalizumab as a way to reduce dupilumab-associated adverse events in severe atopic dermatitis
Fomina, D. S., Mukhina, O. A., Sedova, E. L., Lebedkina, M. S., Bobrikova, E. N., Karaulov, A. V., Lysenko, M. A., & Renz, H.
Frontiers in Allergy20266, Article 1696897
Combined biologic treatment in patient with chronic spontaneous urticaria and Crohn's disease
GarcÃa MartÃnez, A., Lobato de la Sierra, M. P., & Castro Aguilar-Tablada, T.
GastroenterologÃa y HepatologÃa (English Edition)202548(1), Article 502213
Combined treatment with omalizumab and etanercept in a patient with chronic spontaneous urticaria and rheumatoid arthritis
Ghazanfar, M. N., & Thomsen, S. F.
Journal of Dermatological Treatment201930(4), 387–388
Rapid food desensitization supported by omalizumab, with adjunctive dupilumab for type 2 comorbidities: A pediatric case series
Giavina-Bianchi, P., & Giavina-Bianchi, B.
World Allergy Organization Journal202619(4), Article 101374
The Combination of Dupilumab with Other Monoclonal Antibodies
Gisondi, P., Maurelli, M., Costanzo, A., Esposito, M., & Girolomoni, G.
Dermatology and Therapy202213(1), 7–12
Failure of response to combination therapy of adalimumab and infliximab in a recalcitrant patient of severe psoriasis and major thalassemia: A case report
Goldust, M., Rahmatpour Rokni, G., Gupta, M., Lotti, T., & Bathaei, M.
Clinical Case Reports20208(3), 550–552
Safety and efficacy of dual tyrosine kinase 2 inhibitor and monoclonal antibody therapy for psoriasis and psoriatic arthritis
Guénin, S., Andrews, E., & Lebwohl, M. G.
British Journal of Dermatology2024190(3), 451–453
Novel combination biologic therapy for recalcitrant psoriasis and psoriatic arthritis in a medically complex patient
Hanna, S., Youssef, P., & Lowe, P.
Australasian Journal of Dermatology202263(1), e63–e66
Concurrent use of omalizumab and dupilumab in a 47-year-old woman with chronic spontaneous urticaria and atopic dermatitis
Holm, J. G., Sørensen, J. A., & Thomsen, S. F.
International Journal of Dermatology202261(5), e173–e174
The safety and efficacy of dual biological therapy: Dupilumab and fremanezumab
Honigman, A., Oo, H. P., Macdonell, R., & Kern, J. S.
Australasian Journal of Dermatology202465(3), e63–e65
Use of dual biologic therapy targeting the Th2 and Th17 axes simultaneously to treat patients with atopic dermatitis and concomitant psoriasis, psoriatic arthritis, or inflammatory bowel disease
Hren, M. G., Guenin, S., & Khattri, S.
Journal of the American Academy of Dermatology202491(1), 138–140
Treatment of recalcitrant psoriasis and psoriatic arthritis with a combination of a biologic plus an oral JAK or TYK2 inhibitor: a case series
Hren, M. G., & Khattri, S.
Annals of the Rheumatic Diseases202483(10), 1392–1393
Concurrent Atopic Dermatitis and Psoriasis Successfully Treated With Dual Biologic Therapy
Kaszycki, M. A., Pixley, J. N., & Feldman, S. R.
Cutis2023112(3), E13–E16
Rituximab and Omalizumab Combination Therapy for Bullous Pemphigoid
Le, S. T., Herbert, S., Haughton, R., Nava, J., Toussi, A., Ji-Xu, A., & Maverakis, E.
JAMA Dermatology2024160(1), 107–109
Dual Biological Therapy for Ulcerative Colitis with Intractable Pyoderma Gangrenosum
Lee, H. C., Kwon, Y., Kim, E. S., Ahn, S., Choe, Y. H., & Kim, M. J.
Annals of Dermatology202335(Suppl 1), S107–S111
Case Report: Relapsing systemic lupus erythematosus treated with dual rituximab and anifrolumab therapy
Lee, S., Choi, J., Benitez, S., & Lee, J.
Frontiers in Medicine202612, Article 1727404
Psoriasis vulgaris flare during efalizumab therapy does not preclude future use: a case series
Lowes, M. A., Turton, J. A., Krueger, J. G., & Barnetson, R. S.
BMC Dermatology20055(1), Article 9
Dual Biologic Therapy for Psoriasis in a Patient with Atopic Dermatitis
Ma, L., Chen, X., Aziz, M. A. A., Chen, A., Cai, T., & Chen, S.
Psoriasis: Targets and Therapy202515, 159–161
Combination treatment with monoclonal antibodies: Secukinumab, benralizumab and dupilumab for the combined management of psoriasis and severe asthma
Mahar, P. D., Zubrinich, C. M., Manuelpillai, N., & Foley, P.
Australasian Journal of Dermatology202162(4), 506–508
Concurrent Use of Anifrolumab and Belimumab in a Patient With Systemic Lupus Erythematosus Presenting With Recurrent Severe Cutaneous Involvement and Lupus Nephritis
Manjón-RodrÃguez, M. D., Borrego-Utiel, F. J., Merino-GarcÃa, E., Gil-Morillas, A., & Colodro-Ruiz, A.
Cureus202517(11), e97252
Dual biologics for severe asthma and atopic dermatitis: Synopsis of two cases and literature review
Matsumoto, T., Sakurai, Y., Tashima, N., Matoba, T., Kaneko, A., Fujiki, T., Kusakabe, Y., Nakayama, E., Tanaka, A., Tashima, M., Yamamoto, N., & Aihara, K.
Respirology Case Reports202412(1), e01266
Dual Dupilumab and Omalizumab Therapy in Atopic Dermatitis, Chronic Spontaneous Urticaria and Asthma: Real-World Experience From an Eight-Patient Case Series
McClatchy, J., Morgan, V., Scardamaglia, L., Ramirez, A., & Ross, G.
Australasian Journal of Dermatology202667(2), 123–125
Pediatric cutaneous Crohn disease: A case series of 89 patients and review
McKay, G. E., Liu, L., Shaw, K. S., Shakshouk, H., Murphy, M. J., Damsky, W., Ortega-Loayza, A. G., Caplan, A. S., Arkin, L. M., & Shields, B. E.
Pediatric Dermatology202441(5), 807–813
Dual biologic therapy in a patient with severe psoriasis and psoriatic arthritis, using guselkumab and bimekizumab: A case report and review of the literature
Muylaert Barrett, B., Music, M., & Yadav, G.
SAGE Open Medical Case Reports202614, Article 2050313X251411503
Is omalizumab safe and effective in oncological patients?
Navarro-Triviño, F. J., Mérida-Fernández, C., Linares-Gonzalez, L., & Ruiz-Villaverde, R.
Dermatologic Therapy201932(6), e13115
Off-Label Uses of Deucravacitinib for Inflammatory Skin Conditions: Cases and Literature Review
Nigro, A., Silva, I. C., Gerstein, B., Dayanan, J., & Khattri, S.
Case Reports in Dermatological Medicine20262026(1), Article 9941426
An Unusual Case of Psoriasiform Dermatitis Treated With Dual Biologic Therapy and Literature Review
Nong, Y., Marson, J. W., Derrick, K., Heilman, E., Schneider, J., Feig, J. L., & Siegel, D. M.
Journal of Drugs in Dermatology202524(2), 207–211
Combination of Biological Agents in Moderate to Severe Pediatric Inflammatory Bowel Disease: A Case Series and Review of the Literature
Olbjørn, C., Rove, J. B., & Jahnsen, J.
Pediatric Drugs202022(4), 409–416
Combined Biologic Therapy in 2 Patients With Severe Psoriasis and Severe Atopic Dermatitis
Pascual Ares, M., Orbea Sopeña, A., Aramburu González, A., & Gardeazábal GarcÃa, J.
Actas Dermo-Sifiliográficas2024115(5), T527–T529
Combining Biologics Targeting Eosinophils (IL-5/IL-5R), IgE, and IL-4/IL-13 in Allergic and Inflammatory Diseases
Pitlick, M. M., & Pongdee, T.
World Allergy Organization Journal202215(11), Article 100707
Case report: Severe chronic spontaneous urticaria successfully treated with omalizumab and dupilumab
Puxkandl, V., Hoetzenecker, W., & Altrichter, S.
Allergologie Select20237(1), 17–19
Combination therapy including dupilumab, omalizumab, and mycophenolate mofetil for refractory bullous pemphigoid
Ratnarajah, K., Arès, S., Kechichian, E., & Lucena Fernandes, C.
JAAD Case Reports202565, 201–205
Case Report: Combination of Omalizumab and Dupilumab for Recalcitrant Bullous Pemphigoid
Seyed Jafari, S. M., Feldmeyer, L., Bossart, S., Simon, D., Schlapbach, C., & Borradori, L.
Frontiers in Immunology202111, Article 611549
Combined use of Omalizumab and dupilumab: safety and efficacy data from a large academic center
Silva, I. C., Daher, R., & Khattri, S.
Archives of Dermatological Research2025317(1), Article 674
Recalcitrant erythrodermic ichthyosis with atopic dermatitis successfully treated with Dupilumab in combination with Guselkumab
Steinhoff, M., Al-Marri, F., Al Chalabi, R., Gieler, U., & Buddenkotte, J.
Skin Health and Disease20222(1), e87
Dual Biologic Therapy With Dupilumab and Risankizumab for Coexistent Prurigo Nodularis and Psoriasis
Termini, D., Tavoletti, G., Avallone, G., Chiei Gallo, A., Boggio, F. L., Zussino, M., Marzano, A. V., & Ferrucci, S. M.
International Journal of Dermatology202665(4), 901–903
Dual biologic therapy for recalcitrant psoriasis and psoriatic arthritis
Thibodeaux, Q., Ly, K., Reddy, V., Smith, M. P., & Liao, W.
JAAD Case Reports20195(10), 928–930
Combination biologic therapy for the treatment of severe palmoplantar pustulosis
Torre, K. M., & Payette, M. J.
JAAD Case Reports20173(3), 240–242
Severe case of bullous pemphigoid associated with nivolumab responsive to combination therapy with dupilumab and omalizumab
Victory, L., Murray, G., Quigley, C., Bowe, S., Feighery, C., Fortune, A., & McDonald, I.
JAAD Case Reports202557, 98–101
Golimumab in Children with Chronic Recurrent Multifocal Osteomyelitis: A Case Series and Review of the Literature
Yang, C., Rosenwasser, N., Wang, X., Xu, Z., Scheck, J., Boos, M. D., Gupta, D., Brandling-Bennet, H. A., Sidbury, R., Iyer, R. S., & Zhao, Y.
Paediatric Drugs202325(5), 603–611
Contribute
Contribute to the Registry
Clinicians managing patients on concurrent biologic therapy are invited to contribute data. Each submission strengthens the evidence base for concurrent biologic prescribing.
What to Submit
- De-identified patient demographics
- Biologic agents and concurrent therapy details
- Primary diagnosis (ICD-10 coded)
- Duration and clinical outcomes
- Adverse events observed during treatment