In patients with Crohn’s disease on biologic medications, the use of therapeutic drug monitoring leads to a personalized approach to optimize treatment. Using an algorithmic approach, measurement of drug concentrations and anti–drug antibodies can be used to improve treatment outcomes. Therapeutic drug concentrations and absence of antibodies are associated with improved clinical and endoscopic outcomes. In clinical practice, therapeutic drug monitoring has been shown to be clinically useful and cost-effective in patients experiencing a loss of response to treatment. This review highlights the available data on therapeutic drug monitoring in the treatment of patients with Crohn’s disease on biologic medications.
Key points
- •
Therapeutic drug monitoring involves measuring drug concentrations and anti–drug antibodies, which are associated with clinical and endoscopic outcomes.
- •
In patients with a loss of response to anti–tumor necrosis factor therapy, therapeutic drug monitoring is clinically useful and likely cost-effective.
- •
There is evidence for the use of therapeutic drug monitoring in the withdrawal of immunosuppression in combination therapy, dose deescalation, post–drug holiday, and perhaps post-induction monitoring.
- •
Therapeutic drug monitoring in routine maintenance therapy has not yet been shown to improve treatment efficacy.
- •
There is interassay variability, and optimal therapeutic drug and antibody thresholds remain to be firmly established.
Related posts:
Crohn’s Disease
Intestinal and Nonintestinal Cancer Risks for Patients with Crohn’s Disease
Sexuality, Fertility, and Pregnancy in Crohn’s Disease
Targeting Specific Immunologic Pathways in Crohn’s Disease
Interdisciplinary Management of Perianal Crohn’s Disease
Management of Crohn’s Disease After Surgical Resection
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
