Current and Future Status of Therapeutic Drug Monitoring in the Treatment of IBD

Inflammatory Bowel Disease (G Lichtenstein, Section Editor)

DOI: 10.1007/s11938-013-0005-4

Cite this article as:
Khanna, R. & Feagan, B.G. Curr Treat Options Gastro (2014) 12: 76. doi:10.1007/s11938-013-0005-4

Opinion statement

Although tumor necrosis factor (TNF)-antagonists are highly effective agents for the treatment of inflammatory bowel diseases (IBD), up to 40 % of patients ultimately lose response. As a result of the limited availability of treatment options, empiric dose escalation or switching of TNF-antagonists have evolved as strategies to regain response. Recently, therapeutic drug monitoring (TDM) (measurement of serum drug and antidrug antibody concentrations) has emerged to facilitate informed decision-making in patients with secondary loss of response to a TNF-antagonist. The evidence supporting the use of TDM in clinical practice and future applications of this approach will be discussed.

Keywords

Adalimumab Anti-drug-antibodies Crohn’s disease Inflammatory bowel disease Infliximab Therapeutic drug monitoring Ulcerative colitis 

Abbreviations

ADAs

Anti-drug-antibodies

ATIs

Antibodies-to-infliximab

AZA

Azathioprine

Cmax

Maximum drug concentration

CRP

C-reactive protein

IBD

Inflammatory bowel disease

HMSA

HPLC-based mobility shift assay

HPLC

High pressure liquid chromatography

HRP

Horseradish-peroxidase

IFX

infliximab

MTX

Methotrexate

RCT

Randomized controlled trial

TDM

Therapeutic Drug Monitoring

TNF

Tumor necrosis factor

Copyright information

© Springer Science+Business Media, LLC 2014

Authors and Affiliations

  1. 1.Department of Medicine, Robarts Clinical Trials Inc., Robarts Research InstituteUniversity of Western OntarioLondonCanada
  2. 2.Department of Epidemiology and Biostatistics, Robarts Clinical Trials Inc., Robarts Research InstituteUniversity of Western OntarioLondonCanada

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