Svoboda Pavel, Kupka Tomáš
Vnitr Lek. 2020 Winter;66(8):34-38.
Therapeutic drug monitoring is a strategy utilized to optimize biological therapy. It consists in the drug level measurement before the next dose is due, when the drug concentration reaches the trough level, and includes the detection of potential antidrug antibodies. The monitoring makes it possible to adjust the therapy accordingly - to intensify or change the biologics applied to secure safe and highly effective therapeutics. Therapeutic optimization is based on the nature of therapy failure, which can be caused by pharmacokinetic or pharmacodynamic factors. Pharmacokinetic monitoring can be currently classified as reactive, measuring the drug level and antidrug antibodies during therapy failure, or adverse reactions to the drug applied, and proactive, monitoring patients in clinical remission to retain remission and prevents development of a secondary failure.
治疗药物监测是一种用于优化生物治疗的策略。它包括在下一次给药前药物浓度达到谷值时测量药物水平,并检测潜在的抗药物抗体。这种监测使得能够相应地调整治疗——加强或改变所应用的生物制剂,以确保安全且高效的治疗。治疗优化基于治疗失败的性质,其可能由药代动力学或药效学因素引起。目前,药代动力学监测可分为反应性监测,即在治疗失败或对所应用药物出现不良反应时测量药物水平和抗药物抗体;以及前瞻性监测,即在临床缓解期对患者进行监测,以维持缓解状态并防止继发失败的发生。