Therapeutic drug monitoring in inflammatory bowel disease: for every patient and every drug?

Purpose of review The current review provides an updated overview on the role of therapeutic drug monitoring (TDM) of biological therapies in inflammatory bowel disease (IBD). We examine the data behind TDM for the antitumor necrosis factor agents, vedolizumab and ustekinumab, in patients with IBD. In addition, we discuss reactive vs. proactive TDM. Recent findings There is a positive correlation between biologic drug concentrations and favorable therapeutic outcomes in IBD, although the majority of data refer to antitumor necrosis factor therapy. Reactive TDM has rationalized the management of patients with IBD with loss of response to biological therapy. Moreover, reactive TDM of infliximab has been proven to be more cost-effective when compared with empiric dose optimization. Preliminary data suggest that proactive TDM of infliximab and adalimumab applied in patients with clinical response/remission is associated with better therapeutic outcomes compared with standard of care (empiric treatment and/or reactive TDM). Summary For all biologics in IBD, there is a positive correlation between drug concentrations and favorable therapeutic outcomes. Reactive TDM is the new standard of care for optimizing biologic therapies in IBD, whereas recent data suggest an important role of proactive TDM for optimizing antitumor necrosis factor therapy in IBD.
Source: Current Opinion in Gastroenterology - Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Miguel Regueiro Source Type: research

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Introduction: Inflammatory bowel disease (IBD) and hidradenitis suppurativa (HS) are both chronic inflammatory diseases with a big impact in the quality of life of the patients. It has been described a higher prevalence of HS among patients diagnosed with IBD, especially Crohn disease. Some drugs used in HS, such as antibiotics, can be harmful for IBD patients and they may trigger flare ups. Adalimumab is anti-TNF drug which is approved for the treatment of both diseases, being the doses similar in both disorders.
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Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
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