Title of presented paper: Therapy in Crohn's disease with two biologic drugs -- a case report.

Introduction and aim. Inflammatory bowel diseases (IBD) include Crohn's disease. The etiology has not been fully elucidated, however, one pathomechanism is an abnormal immune response. It is likely led by a complex relationship between genetic susceptibility, environmental factors and the gut microbiota. Clinical manifestations during disease exacerbations include abdominal pain, chronic diarrhea and weight loss, which can negatively affect patients' quality of life. Treatment of the disease is multidirectional, and one of the therapeutic options is biological therapy, which includes drugs, such as infliximab, adalimumab, natalizumab, certolizumab, etc. The mechanism of action of adalimumab is to block the connection between tumor necrosis factor alpha and its receptor on the cell, which reduces inflammation, while ustekinumab inhibits interleukin-12 and -23, leading to a reduction in the production of cytokines and inflammatory factors. Description of the case. The patient began his medical history in 2009, when he was admitted to the hospital with persistent abdominal pain, fever and weight loss. During his hospitalization, he underwent repeated laboratory and imaging tests. He was subjected to such therapy, which included the administration of monoclonal antibodies: infliximab, vedolizumab, adalimumab, ustekinumab. After each of the above-mentioned drugs, no satisfactory immune response was achieved. The longest remission, which lasted about 2 years, was achieved after administration of adalimumab. Conclusion. After the patient's clinical condition deteriorated, it was decided, with the approval of the bioethics committee, to start treatment with two biologic drugs. Improvement in the patient's condition was observed after three months when adalimumab and ustekinumab were administered simultaneously. Both of these drugs are described in the scientific literature and used in the treatment of moderate to severe forms of CD. [ABSTRACT FROM AUTHOR]