Sheasgreen Christopher, Nguyen Geoffrey C
Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Joseph and Wolf Lebovic Health Complex, 437-600 University Avenue, Toronto, ON, M5G 1X5, Canada.
Curr Gastroenterol Rep. 2017 May;19(5):19. doi: 10.1007/s11894-017-0559-8.
Biological medications are effective in inflammatory bowel disease (IBD) but adverse events, cost, and loss of response make their use challenging. Therapeutic drug monitoring (TDM) allows clinicians to more safely, effectively, and efficiently use medications. The purpose of this article is to review and summarize the most recent literature pertaining to TDM in IBD.
Measurement of biological drug trough levels predicts ongoing patient response and can be used to titrate the medication to be more effective and efficient. Antibodies against the medications predict loss of response and adverse events. Using both parameters can predict response to subsequent biologicals. Newer biologicals show similar characteristics to those more commonly used. Management protocols using drug and antibody levels optimize medication use and may be cost-effective. Recent evidence suggests benefit to TDM of biologicals in IBD.
生物制剂在炎症性肠病（IBD）中有效，但不良事件、成本和反应丧失使其使用具有挑战性。治疗药物监测（TDM）使临床医生能够更安全、有效和高效地使用药物。本文的目的是回顾和总结IBD中与TDM相关的最新文献。
生物药物谷浓度的测量可预测患者的持续反应，并可用于调整药物剂量以提高疗效和效率。药物抗体可预测反应丧失和不良事件。结合这两个参数可以预测对后续生物制剂的反应。新型生物制剂显示出与常用生物制剂相似的特征。使用药物和抗体水平的管理方案可优化药物使用，且可能具有成本效益。最近的证据表明IBD中生物制剂的TDM有益。
