Saudi Journal of Gastroenterology

REVIEW ARTICLE
Year
: 2022  |  Volume : 28  |  Issue : 5  |  Page : 322--331

Therapeutic drug monitoring for biological medications in inflammatory bowel disease


Rachel C Cogan, Basem W El-Matary, Wael M El-Matary 
 Section of Pediatric Gastroenterology, Department of Pediatric and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada

Correspondence Address:
Dr. Wael M El-Matary
Professor of Pediatric and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, AE 408 Children's Hospital, Health Sciences Centre, 840 Sherbrook St., Winnipeg, Manitoba, R3A 1S1
Canada

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.


How to cite this article:
Cogan RC, El-Matary BW, El-Matary WM. Therapeutic drug monitoring for biological medications in inflammatory bowel disease.Saudi J Gastroenterol 2022;28:322-331


How to cite this URL:
Cogan RC, El-Matary BW, El-Matary WM. Therapeutic drug monitoring for biological medications in inflammatory bowel disease. Saudi J Gastroenterol [serial online] 2022 [cited 2022 Oct 7 ];28:322-331
Available from: https://www.saudijgastro.com/article.asp?issn=1319-3767;year=2022;volume=28;issue=5;spage=322;epage=331;aulast=Cogan;type=0