Could therapeutic drug monitoring of anti-TNF-α be useful to consider a de-escalation of treatment?

Expert Opin Biol Ther. 2015;15(11):1657-60. doi: 10.1517/14712598.2015.1069273. Epub 2015 Jul 20.

Abstract

In recent years, many retrospective studies have demonstrated the interest of therapeutic anti-TNF drug monitoring in inflammatory bowel disease. This could be especially helpful in two different situations: a secondary loss of anti-TNF response where a re-elevation of drug levels by treatment optimization is predictive of better clinical outcome; a therapeutic de-escalation or discontinuation for Crohn's disease patients in long-standing remission where an undetectable anti-TNF drug level could be predictive of clinical remission.

Keywords: anti-TNF; de-escalation; inflammatory bowel disease; trough levels.

Publication types

  • Editorial

MeSH terms

  • Azathioprine / metabolism
  • Azathioprine / therapeutic use
  • Drug Monitoring*
  • Humans
  • Immunologic Factors / metabolism
  • Immunologic Factors / therapeutic use
  • Inflammatory Bowel Diseases / drug therapy
  • Infliximab / metabolism*
  • Infliximab / therapeutic use
  • Recurrence
  • Tumor Necrosis Factor-alpha / immunology*

Substances

  • Immunologic Factors
  • Tumor Necrosis Factor-alpha
  • Infliximab
  • Azathioprine