Therapeutic Drug Monitoring of Biologics for Patients with Inflammatory Bowel Diseases: How, When, and for Whom?

Gut Liver. 2021 Oct 21. doi: 10.5009/gnl210262. Online ahead of print.ABSTRACTDuring the past decade, we have entered an era of biologics for the treatment of Crohn's disease and ulcerative colitis. The therapeutic goal of inflammatory bowel disease (IBD) management has evolved from symptom control and clinical remission to mucosal healing or even deep remission. Histological remission for ulcerative colitis and transmural healing of Crohn's disease are potential future goals. With the adoption of the treat-to-target concept, and given the need for tight control of IBD activity, therapeutic drug monitoring (TDM) is an important element of precision medicine. TDM involves the measurement of serum biologics and anti-drug antibodies levels, to confirm whether the right drug with the right dosage was prescribed to reach the right serum levels. TDM may help clinicians adjust biologics based on objective biomarkers instead of using empirical dosage escalation or making symptom-based therapeutic adjustments. Well-established reactive TDM algorithms have been proposed, and emerging evidence supports the clinical application of a proactive TDM strategy to enhance the duration of effective biologics and improve clinical outcomes. Recently, the proactive TDM strategy was shown to avoid the secondary loss of response to biologics, and improve long-term clinical outcomes in IBD patients. This review summarizes data from trials, and practice guidelines, on the clinical application of proac...
Source: Gut and Liver - Category: Gastroenterology Authors: Source Type: research

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ConclusionIBD-CRC patients were younger and more frequently had right-sided carcinomas compared to sporadic CRC. CRC in IBD patients did not show survival difference compared to matched-pair sporadic CRC patients without distant metastases after curative resection. Surveillance might be important for early detection of CRC in IBD patients.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
Crohn ’s and Colitis Awareness Week will be observed Dec. 1–7, which makes this a good time to learn about living with these disorders. Researchers estimate that more than half a million people in the U.S. have Crohn’s disease, and 600,000 to 900,000 people in the U.S. have ulcerative colitis, accor ding to the National Institute of Diabetes and Digestive and Kidney Diseases. Inflammatory bowel disease is an umbrella term used to describe disorders that involve chronic…
Source: News from Mayo Clinic - Category: Databases & Libraries Source Type: news
aczmarek Andrzej Radzikowski Jarosław Walkowiak The human leukocyte antigen (HLA) allele group HLA-DQA1*05 predisposes to ulcerative colitis (UC) and is associated with the development of antibodies against infliximab in patients with inflammatory bowel disease (IBD). Therefore, we hypothesized that the presence of HLA-DQA1*05 correlates with characteristics of pediatric IBD. Within a multi-center cohort in Poland, the phenotype at diagnosis and worst flare was established and HLA-DQA1*05 status was assessed enabling genotype-phenotype analyses. HLA-DQA1*05 was present in 221 (55.1%) out of 401 children with IBD (...
Source: Genes - Category: Genetics & Stem Cells Authors: Tags: Article Source Type: research
CONCLUSIONS: We found low certainty evidence that transcranial direct current stimulation may improve pain intensity compared to sham stimulation. We could not reach any conclusions on the efficacy of any other interventions on pain intensity, pain frequency, and treatment success. The certainty of the evidence was very low due to the low numbers of studies and participants in each comparison and clinical heterogeneity amongst the studies. While no serious or total adverse events were elicited explicitly with any of the treatments studied, the reported events were very low. The certainty of the evidence for all comparisons...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Source Type: research
AbstractBackgroundInter-alpha-trypsin inhibitor heavy chain 4 (ITIH4) plays vital roles in inflammatory and auto-immune diseases, but its correlations with disease risk and clinical features in inflammatory bowel disease (IBD) need further investigation. The present study intended to explore the correlation of ITIH4 with disease activity and inflammation, as well as its change after treatment in IBD patients.MethodsTotally, 40 active Crohn ’s disease (A-CD) patients, 40 clinical-remission CD (R-CD) patients, 40 active ulcerative colitis (A-UC) patients, 40 clinical-remission UC (R-UC) patients, and 40 health controls...
Source: Irish Journal of Medical Science - Category: General Medicine Source Type: research
CONCLUSION: The rate of MEFV gene mutations was high in patients with UC who required surgery. These patients have frequent and severe attacks, indicating that the mutations are related to disease severity. MEFV mutation as a modifier factor of IBD should be considered.PMID:34819953 | PMC:PMC8608532 | DOI:10.1155/2021/5538150
Source: Gastroenterology Research and Practice - Category: Gastroenterology Authors: Source Type: research
Contributors : Danuta R Gawel ; Jordi Serra-Musach ; Jesper Aagesen ; Alex Arenas ; Bengt Asking ; Malin Bengn ér ; Janne Björkander ; Sophie Biggs ; Jan Ernerudh ; Henrik Hjortswang ; Jan E Karlsson ; Mattias Köpsen ; Eun J Lee ; Antonio Lentini ; Xinxiu Li ; Sandra Lilja ; Mattias Magnusson ; Andreas Matussek ; Colm E Nestor ; Samuel Schäfer ; Oliver Seifert ; Ceylan Sonmez ; Henrik Stjer nman ; Andreas Tjärnberg ; Simon Wu ; Karin Åkesson ; Alex K Shalek ; Margaretha Stenmarker ; Huan Zhang ; Mika Gustafsson ; Mikael BensonSeries Type : Expression profiling by arrayOrganism : Homo sapien...
Source: GEO: Gene Expression Omnibus - Category: Genetics & Stem Cells Tags: Expression profiling by array Homo sapiens Source Type: research
CONCLUSIONS: Trough IFX and ADA concentrations, CRP<5mg/L and FC<100 μg/g are associated with DR during maintenance therapy. Cutoff point of 3.1 and 6.3 g/mL for IFX and ADA respectively, were identified as DR predictors.PMID:34806581
Source: Farmacia Hospitalaria - Category: Drugs & Pharmacology Authors: Source Type: research
CONCLUSIONS: Trough IFX and ADA concentrations, CRP<5mg/L and FC<100 μg/g are associated with DR during maintenance therapy. Cutoff point of 3.1 and 6.3 g/mL for IFX and ADA respectively, were identified as DR predictors.PMID:34806581
Source: Farmacia Hospitalaria - Category: Drugs & Pharmacology Authors: Source Type: research
CONCLUSIONS: Trough IFX and ADA concentrations, CRP<5mg/L and FC<100 μg/g are associated with DR during maintenance therapy. Cutoff point of 3.1 and 6.3 g/mL for IFX and ADA respectively, were identified as DR predictors.PMID:34806581
Source: Farmacia Hospitalaria - Category: Drugs & Pharmacology Authors: Source Type: research
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