Irving Peter M
Department of Gastroenterology, Guy's and St Thomas' Hospital, and Division of Diabetes and Nutritional Sciences, School of Medicine, King's College London, London, UK.
Dig Dis. 2014;32(4):410-8. doi: 10.1159/000358147. Epub 2014 Jun 23.
The use of biologics and thiopurines in patients with inflammatory bowel disease has increased rapidly over the last 2 decades with both classes of drugs being used more frequently and earlier in the disease course. This vogue has come about through a realisation that for some patients Crohn's disease and ulcerative colitis are progressive diseases and that use of these therapies can sometimes prevent that progression. However, knowledge about the optimal way in which to use these drugs continues to evolve. In this paper, the evidence regarding optimal timing and dosing of thiopurines and biologics will be reviewed as will the role of thiopurine methyltransferase testing along with therapeutic drug monitoring of both thiopurines and biologics. In addition, possible future applications of biologic drug level and anti-drug antibody testing will be considered.
在过去20年中，生物制剂和硫唑嘌呤在炎症性肠病患者中的使用迅速增加，这两类药物在疾病过程中使用得更频繁且更早。这种流行趋势的出现是因为人们认识到，对于一些患者来说，克罗恩病和溃疡性结肠炎是进展性疾病，使用这些疗法有时可以阻止疾病进展。然而，关于如何最佳使用这些药物的知识仍在不断发展。在本文中，将回顾关于硫唑嘌呤和生物制剂的最佳使用时机和剂量的证据，以及硫嘌呤甲基转移酶检测的作用，以及硫唑嘌呤和生物制剂的治疗药物监测。此外，还将考虑生物药物水平和抗药物抗体检测未来可能的应用。
