医学
类风湿性关节炎
妥珠单抗
炎症性肠病
药物遗传学
重症监护医学
阿达木单抗
银屑病
个性化医疗
疾病
药品
英夫利昔单抗
临床试验
维多利祖马布
治疗药物监测
药理学
内科学
免疫学
生物信息学
化学
基因型
基因
生物
生物化学
作者
Konstantinos Papamichael,Waqqas Afif,David Drobne,Marla Dubinsky,Marc Ferrante,Peter Irving,Nikolaos Kamperidis,Taku Kobayashi,Paulo Gustavo Kotze,Debabrata Bandyopadhyay,Nurulamin M Noor,Xavier Roblin,Giulia Roda,Niels Vande Casteele,Andrés Yarur,Naila Arebi,Silvio Danese,Stéphane Paul,William J. Sandborn,Séverine Vermeire,Adam S. Cheifetz,Laurent Peyrin–Biroulet
标识
DOI:10.1016/s2468-1253(21)00223-5
摘要
Therapeutic drug monitoring (TDM) has emerged as a useful tool for optimising the use of biologics, and in particular anti-tumour necrosis factor (anti-TNF) therapy, in inflammatory bowel disease (IBD). However, challenges remain and are hindering the widespread implementation of TDM in clinical practice. These barriers include identification of the optimal drug concentration to target, the lag time between sampling and results, and the proper interpretation of anti-drug antibody titres among different assays. Solutions to overcome these barriers include the harmonisation of TDM assays and the use of point-of-care testing. Other unmet needs include well designed prospective studies and randomised controlled trials focusing on proactive TDM, particularly during induction therapy. Future studies should also investigate the utility of TDM for biologics other than anti-TNF therapies in both IBD and other immune-mediated inflammatory diseases such as rheumatoid arthritis and psoriasis, and the use of pharmacokinetic modelling dashboards and pharmacogenetics towards individual personalised medicine.
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