Therapeutic Drug Monitoring in Inflammatory Bowel Disease: History and Future Directions

Elizabeth A Spencer; Marla C Dubinsky

doi:10.1016/j.pcl.2017.08.008

Therapeutic Drug Monitoring in Inflammatory Bowel Disease: History and Future Directions

Pediatr Clin North Am. 2017 Dec;64(6):1309-1326. doi: 10.1016/j.pcl.2017.08.008.

Authors

Elizabeth A Spencer¹, Marla C Dubinsky²

Affiliations

¹ Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine, Mount Sinai, Mt. Sinai Hospital, 1 Gustave L Levy Place, Box 1656, New York, NY 10029, USA.
² Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine, Mount Sinai, Mt. Sinai Hospital, 1 Gustave L Levy Place, Box 1656, New York, NY 10029, USA. Electronic address: marla.dubinsky@mssm.edu.

PMID: 29173787
DOI: 10.1016/j.pcl.2017.08.008

Abstract

Clinical trials for the most effective drugs in the armamentarium of medications for inflammatory bowel disease (IBD) have shown only a 50-60% response rate, and this drops to 30% in maintenance. However, therapeutic drug monitoring (TDM) to adjust dosing to account for patient-specific characteristics, which has been shown to improve outcomes, was not utilized in these trials. This review will detail the development of TDM within the IBD space as it evolved from thiopurines to biologics and continues to evolve with loftier treat-to-target goals and more sophisticated dashboard systems.

Keywords: Biologics; Inflammatory bowel disease; Therapeutic drug monitoring; Thiopurine metabolite monitoring.

Publication types

Review

MeSH terms

Biomarkers / blood
Drug Monitoring / methods*
Humans
Immunosuppressive Agents / therapeutic use*
Inflammatory Bowel Diseases / drug therapy*

Substances

Biomarkers
Immunosuppressive Agents