TY - JOUR
T1 - Key insights from therapeutic drug monitoring in Crohn’s disease patients
AU - Seinen, Margien L.
AU - de Boer, Nanne K.
AU - van Bodegraven, Adriaan A.
PY - 2019/5/4
Y1 - 2019/5/4
N2 - Introduction: The incidence and prevalence of Crohn’s disease are increasing causing a significant disease burden. Therapeutic drug monitoring (TDM) is advocated as a promising tool for personalized or individual-tailored therapy strategies and has been welcomed as a new means to improve current therapy strategies. Nevertheless, pharmacokinetic-based TDM has limitations, and straightforward target concentrations for most therapies are lacking. Areas covered: In the following concise review of literature, key insights of TDM in thiopurine, methotrexate, anti-TNF, vedolizumab and ustekinumab therapy for Crohn’s disease are being described. Expert opinion: Therapeutic drug monitoring may, up till now, be helpful to adjust thiopurine and infliximab therapy, primarily in a reactive setting, in case of inefficacy and of occurrence of adverse event. With this restricted application, the goal of individualized therapy based on TDM has not yet been achieved.
AB - Introduction: The incidence and prevalence of Crohn’s disease are increasing causing a significant disease burden. Therapeutic drug monitoring (TDM) is advocated as a promising tool for personalized or individual-tailored therapy strategies and has been welcomed as a new means to improve current therapy strategies. Nevertheless, pharmacokinetic-based TDM has limitations, and straightforward target concentrations for most therapies are lacking. Areas covered: In the following concise review of literature, key insights of TDM in thiopurine, methotrexate, anti-TNF, vedolizumab and ustekinumab therapy for Crohn’s disease are being described. Expert opinion: Therapeutic drug monitoring may, up till now, be helpful to adjust thiopurine and infliximab therapy, primarily in a reactive setting, in case of inefficacy and of occurrence of adverse event. With this restricted application, the goal of individualized therapy based on TDM has not yet been achieved.
KW - Crohn’s disease
KW - TPMT
KW - anti-TNF
KW - methotrexate
KW - therapeutic drug monitoring
KW - thiopurine
KW - ustekinumab
KW - vedolizumab
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064677132&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30892105
U2 - 10.1080/17425255.2019.1597054
DO - 10.1080/17425255.2019.1597054
M3 - Article
C2 - 30892105
VL - 15
SP - 399
EP - 406
JO - Expert Opinion on Drug Metabolism and Toxicology
JF - Expert Opinion on Drug Metabolism and Toxicology
SN - 1742-5255
IS - 5
ER -