Irving Peter M, Gecse Krisztina B
IBD Unit, Department of Gastroenterology, Guy's and St Thomas' Hospital, London, United Kingdom; School of Immunology and Microbial Sciences, King's College London, London, United Kingdom.
Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, the Netherlands.
Gastroenterology. 2022 Apr;162(5):1512-1524. doi: 10.1053/j.gastro.2022.02.014. Epub 2022 Feb 12.
Therapeutic drug monitoring (TDM) has emerged as a strategy for treatment optimization in inflammatory bowel diseases to maximize benefit and to reach more stringent, objective end points. Optimal drug concentrations in inflammatory bowel disease vary according to treatment target, disease phenotype, inflammatory burden, and timing of sampling during the treatment cycle. This review provides an update on TDM with biologic and oral small molecules, evaluates the role of reactive vs proactive TDM, and identifies the gaps in current evidence. In the future, adaptations to how we use TDM may contribute further to the goal of personalized treatment in patients with IBD.
治疗药物监测（TDM）已成为炎症性肠病治疗优化的一种策略，以实现效益最大化并达到更严格、客观的终点。炎症性肠病中的最佳药物浓度因治疗靶点、疾病表型、炎症负担以及治疗周期中的采样时间而异。本综述提供了关于生物制剂和口服小分子药物的TDM的最新情况，评估了反应性TDM与前瞻性TDM的作用，并确定了当前证据中的差距。未来，我们对TDM使用方式的调整可能会进一步有助于实现炎症性肠病患者个性化治疗的目标。
