Concurrent Biologics Registry

Advancing the Science of Concurrent Biologic Therapy

Prospective data on concurrent biologic use remain limited. This registry changes that, aggregating real-world outcomes from published literature and de-identified clinical submissions worldwide to bridge the gap between clinical practice and systematic evidence.

92%

Positive Outcomes

30

Biologic Pairs

42

Diagnoses

The Problem

A Critical Gap in the Evidence Base

There is no shared record of how concurrent biologic therapy performs across specialties. Clinicians decide one case at a time, on partial information.

In clinical practice, a growing number of patients present with overlapping immune-mediated conditions or with disease refractory to single-agent therapy, creating clinical scenarios where concurrent biologic use becomes a consideration. These situations span gastroenterology, rheumatology, dermatology, and other disciplines, yet the evidence base has not kept pace with the clinical need.

Clinicians are left relying on isolated case reports and extrapolation rather than aggregated, systematic data on safety, efficacy, and pharmacologic 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

Consolidating cases that would otherwise remain isolated in individual publications or unreported in clinical practice, enabling pattern recognition across a growing body of evidence.

Multi-Center, International

Aggregating real-world data from published literature and clinical submissions across diverse clinical sites globally, reflecting the complexity of actual patient populations.

Toward Consensus

As the evidence base grows, aggregated data from the registry can inform the development of consensus recommendations and best-practice guidance for concurrent biologic prescribing across specialties.

How It Works

A Dual-Source Evidence Model

The registry captures both published evidence and unpublished clinical experience through two complementary data pathways.

1

Published Literature

Cases documented in peer-reviewed journals, including case reports, case series, and observational studies, are identified, extracted, and catalogued in a standardized format.

2

Clinical Submissions

Healthcare professionals submit de-identified case data following a structured template that captures only aggregate clinical variables such as age bracket, sex, diagnosis, biologic agents, and outcomes.

3

Quality Review

Each submission undergoes a structured quality review for completeness, clinical plausibility, and consistency before inclusion in the registry.

Clinical scope

Conditions and biologics

For each case, the registry captures de-identified demographic data (age bracket, sex), the specific biologic agents prescribed, primary diagnosis coded to ICD-10, duration of concurrent therapy, concomitant systemic medications, clinical outcome on a standardized scale, and any adverse events observed during treatment. No personally identifiable health information is collected at any stage.

Conditions in Scope

The registry accepts cases across immune-mediated inflammatory diseases. Examples include:

Psoriasis & Psoriatic ArthritisAtopic DermatitisChronic Spontaneous UrticariaInflammatory Bowel DiseaseRheumatoid ArthritisAxial SpondyloarthritisAutoimmune Blistering Diseases+ many more

Biologics in Scope

Submissions may involve any biologic agent, recorded by class or individual molecule. Examples include:

TNF-alpha InhibitorsIL-17 InhibitorsIL-23 InhibitorsIL-12/23 InhibitorsIL-4/IL-13 Pathway BlockersAnti-IgE AgentsB-cell Depleting Therapies+ many more

By the Numbers

Registry at a Glance

Real-world evidence from concurrent biologic therapy across published literature and clinical submissions.

0

Unique Biologic Pairs

0%

Positive Outcomes

0%

Adverse Events Reported

0%

Concomitant Systemic Therapy

Drug Combinations

Biologic Combination Explorer

Patient-level outcome data for each biologic combination can be viewed by selecting a cell.

Biologic combination patient count heatmap

Omalizumab
Dupilumab
Ustekinumab
Guselkumab
Rituximab
Adalimumab
Etanercept
Infliximab
Secukinumab
Vedolizumab
Golimumab
Mepolizumab
Evolocumab
Efalizumab
Trastuzumab
Risankizumab
Tildrakizumab
Cetuximab
Abatacept
Omalizumab
Dupilumab
Ustekinumab
Guselkumab
Rituximab
Adalimumab
Etanercept
Infliximab
Secukinumab
Vedolizumab
Golimumab
Mepolizumab
Evolocumab
Efalizumab
Trastuzumab
Risankizumab
Tildrakizumab
Cetuximab
Abatacept
Fewer
More

Clinical Outcomes

Treatment Response and Demographics

Outcome categorization and demographic distribution across the registry cohort.

Outcome category

Age distribution

Treatment Patterns

Duration and Prescribing Trends

Duration of concurrent therapy and prescribing frequency across the cohort.

Treatment duration

Most prescribed biologics

Safety Data

Adverse Event Profile

The registry tracks adverse events by sex to identify demographic patterns in safety outcomes. All reported events are captured regardless of severity or attribution.

Adverse events by sex

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

Every dataset, visualization, and analysis is freely available without registration, login, or payment.

Independent

The registry operates fully independently of pharmaceutical companies, drug manufacturers, and trade groups. None influence its scope, methodology, or content.

No industry funding

No pharmaceutical industry funding supports this work. The registry receives no payment, sponsorship, or compensation from drug manufacturers.

Trust and transparency

Built on rigor, designed for openness

The Concurrent Biologics Registry is a freely accessible quality assurance and practice improvement resource. It consolidates published and clinician-submitted evidence into a single repository, lowering the barrier to both contributing and accessing real-world data on concurrent biologic therapy.

De-identified by design

Data collection is structured to capture only aggregate clinical variables, including age band, sex, disease category, biologic agents, and outcomes. Personally identifiable information is never requested, collected, or stored.

Open-access data

The full registry and all visualizations are freely available without registration. No barriers between clinicians and the evidence they need at the point of care.

Structured quality review

Every submitted case undergoes a structured quality review before inclusion, ensuring data quality and clinical accuracy.

Multi-Center Collaboration

Data sourced from published literature and de-identified clinical submissions contributed by clinicians worldwide, reflecting an international collaborative effort.

Common Questions

Frequently Asked Questions

Answers to common questions about the Concurrent Biologics Registry, its data, and how to participate.

Concurrent biologic therapy refers to the simultaneous use of two or more biologic medications in a single patient. This typically arises when a patient has multiple immune-mediated conditions, each requiring a distinct biologic agent with a different mechanism of action.
Any licensed healthcare professional managing patients on concurrent biologic therapy. Submissions are accepted from any institution worldwide and undergo structured quality review before inclusion. The registry collects only de-identified, non-identifiable clinical data for quality assurance purposes.
The registry is designed so that personally identifiable health information is never collected. The submission template captures only aggregate clinical variables: age band, biological sex, disease category, biologic agents, duration of therapy, clinical outcomes, adverse events, care setting, and continent-level geographic region. No patient names, dates of birth, treatment dates, medical record numbers, addresses, or other information that could enable patient re-identification is requested at any stage.
The registry draws from two complementary sources. Published literature: case reports, case series, and observational studies are systematically identified, extracted, and catalogued in a standardized format. Clinician-submitted cases follow a structured de-identified template and undergo quality review before inclusion.
The registry supports clinical decision-making when concurrent biologic therapy is considered, identification of safety signals across biologic combinations not studied in formal trials, and the development of future consensus recommendations for concurrent prescribing. All data and visualizations are freely accessible without registration.

Literature

References

32 peer-reviewed sources, 2005–2026

  1. 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

  2. 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 Martín, F. J.

    Australasian Journal of Dermatology202465(1), 63–66

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. Dual biologic therapy in a patient with severe asthma and other allergic disorders

    Caskey, J. R., & Kaufman, D.

    BMJ Case Reports202114(5), e242211

  11. 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

  12. 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

  13. Combination Biologic Treatment of Refractory Psoriasis and Psoriatic Arthritis

    Cuchacovich, R., Garcia-Valladares, I., & Espinoza, L. R.

    The Journal of Rheumatology201239(1), 187–193

  14. 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

  15. 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

  16. The use of dual biologic therapy for the management of recalcitrant psoriasis

    Finnegan, P., Murphy, M., & Bourke, J.

    JAAD Case Reports202447, 93–95

  17. 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

  18. Combined biologic treatment in patient with chronic spontaneous urticaria and Crohn's disease

    García Martínez, A., Lobato de la Sierra, M. P., & Castro Aguilar-Tablada, T.

    Gastroenterología y Hepatología (English Edition)202548(1), Article 502213

  19. 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

  20. 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

  21. The Combination of Dupilumab with Other Monoclonal Antibodies

    Gisondi, P., Maurelli, M., Costanzo, A., Esposito, M., & Girolomoni, G.

    Dermatology and Therapy202213(1), 7–12

  22. 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

  23. 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

  24. Concurrent Atopic Dermatitis and Psoriasis Successfully Treated With Dual Biologic Therapy

    Kaszycki, M. A., Pixley, J. N., & Feldman, S. R.

    Cutis2023112(3), E13–E16

  25. 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

  26. 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

  27. 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

  28. 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

  29. 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

  30. 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

  31. 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

  32. 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