Highs and Lows of Proactive Therapeutic Drug Monitoring in Crohn’s Patients

Rakowsky, Shana; Feuerstein, Joseph D.

doi:10.1007/s10620-020-06774-6

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…In the last decade, several studies have been conducted to assess TDM and its potential benefits to the management of anti-TNF treatment in IBD. Although recent studies have provided convincing evidence of the benefits of proactive TDM (11,12), other trials and observational studies have failed to demonstrate advantages from this practice (1,(8)(9)(10)(17)(18)(19)(20). As a consequence of the evolving evidence, the recommendations provided by international guidelines have required adjustments over time (2,13,14), and further evidence is still needed before proactive TDM can be universally recommended (15)(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

“…At present, more evidence is needed to elucidate the advantages of using proactive TDM in paediatric patients with IBD treated with anti-TNF (15)(16)(17)(18)(19)(20). The aim of this study was therefore to investigate whether proactive TDM in an established cohort of paediatric patients with IBD treated with anti-TNF would improve patient disease management and disease outcomes by reducing the risk of LoR.…”

Section: What Is Newmentioning

confidence: 99%

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Advantages of Proactive Therapeutic Drug Monitoring in a Prospective Cohort of Children With Inflammatory Bowel Disease Treated With Anti‐Tumour Necrosis Factor

Gasparetto

Burgess

Naik

et al. 2022

J. pediatr. gastroenterol. nutr.

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Few studies have addressed whether proactive therapeutic drug monitoring (TDM) results in improved clinical outcomes in children with inflammatory bowel disease (IBD) treated with anti-tumour necrosis factor. The aim of this study was to investigate the impact of using proactive TDM in this patient group. Pilot single-centre observational study to accrue data on patients managed with proactive TDM. More patients in the proactive TDM cohort were managed by escalating the infliximab (IFX) regime (P < 0.001). The need for switching to different biologics was significantly lower in this patient group (P < 0.001). The introduction of proactive TDM resulted in a significant reduction of patients requiring switch of their primary biologic. The results of this study are indicators that proactive TDM offers a better method of managing children with IBD on IFX therapy.

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Section: Discussionmentioning

confidence: 99%

Section: What Is Newmentioning

confidence: 99%

Advantages of Proactive Therapeutic Drug Monitoring in a Prospective Cohort of Children With Inflammatory Bowel Disease Treated With Anti‐Tumour Necrosis Factor

Gasparetto

Burgess

Naik

et al. 2022

J. pediatr. gastroenterol. nutr.

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“…[ 84 ] Most IBD patients are already consumed by frequent appointments and testing; therefore, it is important to consider the additional costs incurred by added testing. [ 85 86 ] However, these potential costs must be compared to those that are associated with a change in therapy due to a loss of response or an IBD flare. [ 84 ]…”

Section: Proactive Therapeutic Drug Monitoringmentioning

confidence: 99%

Therapeutic drug monitoring for biological medications in inflammatory bowel disease

Cogan

El-Matary

2022

Saudi Journal of Gastroenterology

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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.

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Highs and Lows of Proactive Therapeutic Drug Monitoring in Crohn’s Patients

Cited by 2 publications

References 7 publications

Advantages of Proactive Therapeutic Drug Monitoring in a Prospective Cohort of Children With Inflammatory Bowel Disease Treated With Anti‐Tumour Necrosis Factor

Advantages of Proactive Therapeutic Drug Monitoring in a Prospective Cohort of Children With Inflammatory Bowel Disease Treated With Anti‐Tumour Necrosis Factor

Therapeutic drug monitoring for biological medications in inflammatory bowel disease

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