Department of Clinical Pharmacology, Christchurch Hospital, 2 Riccarton Avenue, Christchurch 8011, New Zealand.
Department of Clinical Pharmacology, Christchurch Hospital, 2 Riccarton Avenue, Christchurch 8011, New Zealand; Department of Gastroenterology, Christchurch Hospital, 2 Riccarton Avenue, Christchurch 8011, New Zealand; Christchurch Campus, School of Medicine, University of Otago PO Box 4345, Christchurch 8140, New Zealand.
Curr Opin Pharmacol. 2020 Dec;55:41-46. doi: 10.1016/j.coph.2020.09.006. Epub 2020 Oct 26.
Inflammatory bowel disease (IBD) is increasingly common, and results in significant morbidity. Traditional therapies include corticosteroids, aminosalicylates, thiopurines and methotrexate but in more recent years biologics have transformed the management of IBD. However, these agents come with a significant financial cost, making them unavailable for many patients worldwide. Therapeutic drug monitoring (TDM) is an important means to optimise clinical outcomes from pharmacotherapy. Recent studies have also focussed on the cost-effectiveness as an outcome of TDM. TDM of traditional therapies is principally mediated through improved disease control. Cost-savings from TDM of biologic therapies arises mainly from reduced pharmaceutical use with equitable clinical outcomes. This review considers the cost-effectiveness of TDM for IBD therapies, with a focus on recent research into biologic TDM.
炎症性肠病（IBD）越来越常见，导致发病率显著增加。传统疗法包括皮质类固醇、氨基水杨酸盐、硫嘌呤和甲氨蝶呤，但近年来生物制剂改变了 IBD 的治疗模式。然而，这些药物的费用很高，使它们在世界范围内无法为许多患者所用。治疗药物监测（TDM）是优化药物治疗临床效果的重要手段。最近的研究也集中在 TDM 的成本效益作为一个结果。传统疗法的 TDM 主要通过改善疾病控制来实现。生物制剂 TDM 的成本节约主要来自于减少药物使用，同时保持平等的临床效果。这篇综述考虑了 TDM 对 IBD 治疗的成本效益，重点是最近关于生物 TDM 的研究。
