Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang 110022, Liaoning Province, China.
World J Gastroenterol. 2022 Apr 21;28(15):1604-1607. doi: 10.3748/wjg.v28.i15.1604.
Recently, biological drugs have played a leading role in the treatment of inflammatory bowel disease, and therapeutic drug monitoring (TDM) may be useful in maximizing their effectiveness. TDM involves the measurement of serum drug and anti-drug antibodies concentrations as the basis for dosage adjustments or drug conversions to achieve a higher response rate. We believe that concentration thresholds should be individualized based on patients' disease severity, extent and phenotype, and therapeutic purposes should also be considered, with higher cut-offs mainly needed for endoscopic and fistula healing than for symptomatic remission. Proactive and reactive TDM can help optimize treatment, especially in patients receiving anti-tumour necrosis factor, and guide dose adjustment or drug conversion with lower cost. TDM is a promising approach to achieve precision medicine and targeted medicine in the future.
最近，生物药物在炎症性肠病的治疗中发挥了主导作用，治疗药物监测（TDM）可能有助于最大限度地提高其疗效。TDM 包括测量血清药物和抗药物抗体浓度，作为剂量调整或药物转换的基础，以实现更高的反应率。我们认为，浓度阈值应根据患者的疾病严重程度、程度和表型进行个体化，还应考虑治疗目的，内镜和瘘管愈合所需的截止值高于症状缓解。主动和被动 TDM 有助于优化治疗，特别是在接受抗肿瘤坏死因子治疗的患者中，并以较低的成本指导剂量调整或药物转换。TDM 是实现未来精准医学和靶向医学的有前途的方法。
