Top 20 high-impact clinical research articles of 2024 in Gastroenterology:Episode 10

Clinical Gastroenterology and Hepatology Vedolizumab, Adalimumab, and Methotrexate Combination Therapy in Crohn’s Disease (EXPLORER)Volume 22, Issue 7P1487-1496.E12July 2024The EXPLORER study investigated whether a triple combination therapy—specifically using vedolizumab, adalimumab, and methotrexate—could improve treatment outcomes for individuals with newly diagnosed, moderate-to-high-risk Crohn's disease, recognizing that the effectiveness of single biologic agents has reached a plateau. This phase 4, single-arm trial measured success primarily by achieving endoscopic remission by week 26 and secondarily by clinical remission, finding that 34.5% of patients met the primary endpoint and over half achieved clinical remission. Crucially, the analysis suggested a high probability that this combination outperformed monotherapies, indicating that this intensified regimen warrants further study as a promising path forward despite some patients experiencing serious adverse events.