Department of Gastroenterology, Erasme Hospital, ULB, Brussels, Belgium; Laboratory of Experimental Gastroenterology, ULB, Brussels, Belgium.
Department of Gastroenterology, Erasme Hospital, ULB, Brussels, Belgium; Laboratory of Experimental Gastroenterology, ULB, Brussels, Belgium.
Curr Opin Pharmacol. 2020 Dec;55:82-89. doi: 10.1016/j.coph.2020.10.003. Epub 2020 Nov 6.
Inflammatory bowel disease patients do not all respond to biological treatment since several patients will initially respond but will lose response or develop side effects over time. In such cases, a switch from one biologic to another offers a valuable clinical solution. This requires to evaluate both patient and drug profiles in combination with the reason(s) for switching in order to adequately select the second-line biologic. Therapeutic drug monitoring is obviously a useful tool but is currently limited to the use of anti-TNFα. In this review paper, we provide overview and guidance on switching biologics in clinical practice, with the emphasis on the motivations for switching, the selection of the second-line biologic, as well as explanations on how and when to switch.
炎症性肠病患者并非对所有生物治疗都有反应，因为一些患者最初会有反应，但随着时间的推移会失去反应或出现副作用。在这种情况下，从一种生物制剂转换为另一种生物制剂提供了一个有价值的临床解决方案。这需要结合转换的原因评估患者和药物特征，以便充分选择二线生物制剂。治疗药物监测显然是一种有用的工具，但目前仅限于使用抗 TNFα。在这篇综述论文中，我们提供了在临床实践中切换生物制剂的概述和指导，重点介绍了切换的动机、二线生物制剂的选择，以及如何和何时切换的解释。
