A Practical Guide to Therapeutic Drug Monitoring of Biologic Medications for Inflammatory Bowel Disease

Therapeutic drug monitoring (TDM) is a useful strategy to optimize biologic medications for inflammatory bowel disease not responsive to standard dosing regimens. TDM is cost effective for anti-tumor necrosis factor agents in the setting of loss of response (reactive TDM). Optimizing drug dosing whe...

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Autor principal:	Byron P. Vaughn
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	infliximab adalimumab vedolizumab ustekinumab Crohn’s disease ulcerative colitis Medicine R
Acceso en línea:	https://doaj.org/article/c687800ac5f44d32a4a67e75fb227378
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spelling	oai:doaj.org-article:c687800ac5f44d32a4a67e75fb2273782021-11-11T17:37:11ZA Practical Guide to Therapeutic Drug Monitoring of Biologic Medications for Inflammatory Bowel Disease10.3390/jcm102149902077-0383https://doaj.org/article/c687800ac5f44d32a4a67e75fb2273782021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4990https://doaj.org/toc/2077-0383Therapeutic drug monitoring (TDM) is a useful strategy to optimize biologic medications for inflammatory bowel disease not responsive to standard dosing regimens. TDM is cost effective for anti-tumor necrosis factor agents in the setting of loss of response (reactive TDM). Optimizing drug dosing when patients are in remission (proactive TDM) may be beneficial in certain circumstances. However, frequently the serum drug concentration in isolation becomes the focus TDM. Additionally, the lines of reactive and proactive TDM can quickly blur in many common clinical settings. Physicians employing a TDM based strategy need to place the drug concentration in context with the inflammatory status of the patient, the underlying pharmacokinetics and pharmacodynamics of the drug, the risk of immunogenicity, and the therapeutic goals for the patient. Physicians should understand the limits of TDM and feel comfortable making therapeutic decisions with imperfect information. The goal of this narrative review is to provide a framework of questions that physicians can use to employ TDM effectively in practice.Byron P. VaughnMDPI AGarticleinfliximabadalimumabvedolizumabustekinumabCrohn’s diseaseulcerative colitisMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4990, p 4990 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	infliximab adalimumab vedolizumab ustekinumab Crohn’s disease ulcerative colitis Medicine R
spellingShingle	infliximab adalimumab vedolizumab ustekinumab Crohn’s disease ulcerative colitis Medicine R Byron P. Vaughn A Practical Guide to Therapeutic Drug Monitoring of Biologic Medications for Inflammatory Bowel Disease
description	Therapeutic drug monitoring (TDM) is a useful strategy to optimize biologic medications for inflammatory bowel disease not responsive to standard dosing regimens. TDM is cost effective for anti-tumor necrosis factor agents in the setting of loss of response (reactive TDM). Optimizing drug dosing when patients are in remission (proactive TDM) may be beneficial in certain circumstances. However, frequently the serum drug concentration in isolation becomes the focus TDM. Additionally, the lines of reactive and proactive TDM can quickly blur in many common clinical settings. Physicians employing a TDM based strategy need to place the drug concentration in context with the inflammatory status of the patient, the underlying pharmacokinetics and pharmacodynamics of the drug, the risk of immunogenicity, and the therapeutic goals for the patient. Physicians should understand the limits of TDM and feel comfortable making therapeutic decisions with imperfect information. The goal of this narrative review is to provide a framework of questions that physicians can use to employ TDM effectively in practice.
format	article
author	Byron P. Vaughn
author_facet	Byron P. Vaughn
author_sort	Byron P. Vaughn
title	A Practical Guide to Therapeutic Drug Monitoring of Biologic Medications for Inflammatory Bowel Disease
title_short	A Practical Guide to Therapeutic Drug Monitoring of Biologic Medications for Inflammatory Bowel Disease
title_full	A Practical Guide to Therapeutic Drug Monitoring of Biologic Medications for Inflammatory Bowel Disease
title_fullStr	A Practical Guide to Therapeutic Drug Monitoring of Biologic Medications for Inflammatory Bowel Disease
title_full_unstemmed	A Practical Guide to Therapeutic Drug Monitoring of Biologic Medications for Inflammatory Bowel Disease
title_sort	practical guide to therapeutic drug monitoring of biologic medications for inflammatory bowel disease
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/c687800ac5f44d32a4a67e75fb227378
work_keys_str_mv	AT byronpvaughn apracticalguidetotherapeuticdrugmonitoringofbiologicmedicationsforinflammatoryboweldisease AT byronpvaughn practicalguidetotherapeuticdrugmonitoringofbiologicmedicationsforinflammatoryboweldisease
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A Practical Guide to Therapeutic Drug Monitoring of Biologic Medications for Inflammatory Bowel Disease

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