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- Title
Therapeutic drug monitoring for biological medications in inflammatory bowel disease.
- Authors
Cogan, Rachel; El-Matary, Basem; El-Matary, Wael
- Abstract
Therapeutic drug monitoring (TDM) is the measurement of serum drug concentrations and anti-drug-antibodies (ADA) for biologic therapies used to treat inflammatory bowel disease (IBD). The aim of this article is to review the current literature concerning reactive and proactive TDM for both adults and children with IBD. Although optimal trough concentration windows for some of these medications are not well defined, there is mounting evidence to suggest that reactive TDM is associated with favorable therapeutic outcomes, including less immunogenicity, greater drug exposure, and a decreased risk of treatment failure. Moreover, while the exact mechanism of loss of response is not fully elucidated, the vast majority of studies have reported a decreased incidence of nonresponse and secondary loss of response when TDM is implemented. Proactive TDM, while even less understood in the literature, employs a schedule of preemptive analysis of serum trough concentrations to accordingly adjust the patient's biologic dosage. Proactive TDM may decrease the need for IBD-related surgery/hospitalization, and therefore merits future studies of investigation.
- Subjects
BIOLOGICAL products; INFLAMMATORY bowel diseases; VANCOMYCIN; INFLIXIMAB; TREATMENT effectiveness; TREATMENT failure; DRUG monitoring; HOSPITAL care; ADALIMUMAB; CHILDREN; ADULTS
- Publication
Saudi Journal of Gastroenterology, 2022, Vol 28, Issue 5, p322
- ISSN
1319-3767
- Publication type
Article
- DOI
10.4103/sjg.sjg_3_22