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炎症性肠病中的模型指导精准给药

Model-informed precision dosing in inflammatory bowel diseases.

作者信息

Bourgonje Arno R, Dubinsky Marla C, Keizer Ron J, Dreesen Erwin, Mian Paola

机构信息

The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

出版信息

Trends Pharmacol Sci. 2025 Jan;46(1):9-19. doi: 10.1016/j.tips.2024.11.003. Epub 2024 Dec 3.

Abstract

Therapeutic drug monitoring (TDM) for biologic therapies in inflammatory bowel disease (IBD) primarily aims to optimize dosing. However, several unmet needs remain. These include the identification of optimal drug concentrations, accounting for variability in pharmacokinetics (PK) and pharmacodynamics (PD), and the frequent delays between sampling and clinical decision-making. Recent technical advances, such as population PK/PD modeling and model-informed precision dosing (MIPD) tools developed from such models, as well as point-of-care (POC) and self-sampling assays and novel software programs, offer potential solutions. Successful implementation of these innovations may help to establish MIPD for patients with IBD. This would enable personalized dosing, advancing a one-size-fits-all approach to TDM that currently is inadequate to fulfill the needs for every patient with IBD.

摘要

炎症性肠病(IBD)生物治疗的治疗药物监测(TDM)主要旨在优化给药剂量。然而,仍存在一些未满足的需求。这些需求包括确定最佳药物浓度、考虑药代动力学(PK)和药效学(PD)的变异性,以及采样与临床决策之间频繁出现的延迟。最近的技术进步,如群体PK/PD建模以及基于此类模型开发的模型指导精准给药(MIPD)工具,还有即时检验(POC)和自我采样检测以及新型软件程序,都提供了潜在的解决方案。成功实施这些创新可能有助于为IBD患者建立MIPD。这将实现个性化给药,推动目前不足以满足每位IBD患者需求的一刀切TDM方法的改进。

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