Therapeutic Drug Monitoring in IBD: Biologics

[DustyKat]

A paradigm in the evolution of care.

Similar to when thiopurine drug monitoring was introduced in the early 2000s, physicians treating patients with inflammatory bowel disease are currently faced with a parallel question regarding how to choose the optimal dosing regimen for patients receiving biologics.

According to experts interviewed by Healio Gastroenterology, however, therapeutic drug monitoring of biologics is far more complex than with thiopurines, largely due to issues stemming from the development of antidrug antibodies that interfere with biologic activity.

Although the utilization of drug monitoring to provide tailored therapies with anti-tumor necrosis factor agents for patients with IBD is on the rise, lack of knowledge among clinicians, insufficient prospective data on outcomes and optimal therapeutic ranges, technological limitations of commercially available assays and cost issues continue to stand in the way of more widespread and optimized implementation. Despite these current barriers and uncertainties, experts said the growing body of evidence supports the rationale for clinicians to improve their understanding of factors that influence the pharmacokinetics of biologics and utilize therapeutic drug monitoring to optimize patient outcomes and reduce the costs of biologic therapies.

Source:
http://www.healio.com/gastroenterology/inflammatory-bowel-disease/news/print/healio-gastroenterology/%7B6eb50c6a-5504-4541-a420-3ffa003f5b40%7D/therapeutic-drug-monitoring-in-ibd

NOTE:
I have only quoted the opening paragraphs here. The article is a lengthy one so click on the source and you will find as you reach the end of the first page there are another 4 to follow.

It is well worth the read.

 

[FrozenGirl]

Wow fascinating. I was especially interested in the bit about mexotrexate and how different thiopurines affect clearance of biologics.

 

[Lady Organic]

so according to the study of dr Dubinski, methotrexate at more than 15mg/week would be more reliable than thiopurines to prevent anti-body formation while on biologics? I wonder how many subjects there was in her study...

 

[xeridea]

Janssen just announced that they will offer two therapeutic drug monitoring tests per year free for patients on Remicade.

http://www.gastro.org/news_items/ja...-drug-monitoring-for-ibd-patients-on-remicade

 

[FrozenGirl]

Interesting. In Canada we already get a free one from Janssen so I'm pleased to here they expanded it into the states.

 

[Pilgrim]

Wish it was the same for Humira. I understand there isn't a clear understanding of levels.