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Optimizing Therapies Using Therapeutic Drug Monitoring: Current Strategies and Future Perspectives

Research output: Contribution to journalArticlepeer-review

Peter M. Irving, Krisztina B. Gecse

Original languageEnglish
Pages (from-to)1512-1524
Number of pages13
JournalGastroenterology
Volume162
Issue number5
DOIs
PublishedApr 2022

Bibliographical note

Funding Information: Conflicts of interest Peter M. Irving has received honoraria for speaking on behalf of AbbVie, BMS, Celgene, Celltrion, Falk Pharma, Ferring, Galapagos, Gilead, MSD, Janssen, Lilly, Pfizer, Takeda, Tillotts, Sapphire Medical, Sandoz, Shire, Warner Chilcott, and for acting in an advisory capacity to AbbVie, Arena, Boehringer-Ingelheim, BMS, Celgene, Celltrion, Genentech, Gilead, Hospira, Janssen, Lilly, MSD, Pfizer, Pharmacosmos, Prometheus, Roche, Sandoz, Samsung Bioepis, Takeda, Topivert, VH2, Vifor Pharma, and Warner Chilcott, and has received research grants from Celltrion, Galapagos, MSD, Pfizer, and Takeda. Krisztina B. Gecse has received grants from Pfizer Inc and Celltrion, consultancy fees from AbbVie, Arena Pharmaceuticals, Galapagos, Gilead, Immunic Therapeutics, Janssen Pharmaceuticals, Novartis, Pfizer Inc, Samsung Bioepis, and Takeda, and speaker's honoraria from Celltrion, Ferring, Janssen Pharmaceuticals, Novartis, Pfizer Inc, Samsung Bioepis, Takeda, and Tillotts. Funding PMI is supported by a grant from the Medical Research Council (MR/T005564/1). Funding Information: Conflicts of interest Peter M. Irving has received honoraria for speaking on behalf of AbbVie, BMS, Celgene, Celltrion, Falk Pharma, Ferring, Galapagos, Gilead, MSD, Janssen, Lilly, Pfizer, Takeda, Tillotts, Sapphire Medical, Sandoz, Shire, Warner Chilcott, and for acting in an advisory capacity to AbbVie, Arena, Boehringer-Ingelheim, BMS, Celgene, Celltrion, Genentech, Gilead, Hospira, Janssen, Lilly, MSD, Pfizer, Pharmacosmos, Prometheus, Roche, Sandoz, Samsung Bioepis, Takeda, Topivert, VH2, Vifor Pharma, and Warner Chilcott, and has received research grants from Celltrion, Galapagos, MSD, Pfizer, and Takeda. Krisztina B. Gecse has received grants from Pfizer Inc and Celltrion, consultancy fees from AbbVie, Arena Pharmaceuticals, Galapagos, Gilead, Immunic Therapeutics, Janssen Pharmaceuticals, Novartis, Pfizer Inc, Samsung Bioepis, and Takeda, and speaker’s honoraria from Celltrion, Ferring, Janssen Pharmaceuticals, Novartis, Pfizer Inc, Samsung Bioepis, Takeda, and Tillotts. Funding Information: Funding PMI is supported by a grant from the Medical Research Council (MR/T005564/1). Publisher Copyright: © 2022 AGA Institute

King's Authors

Abstract

Therapeutic drug monitoring (TDM) has emerged as a strategy for treatment optimization in inflammatory bowel diseases to maximize benefit and to reach more stringent, objective end points. Optimal drug concentrations in inflammatory bowel disease vary according to treatment target, disease phenotype, inflammatory burden, and timing of sampling during the treatment cycle. This review provides an update on TDM with biologic and oral small molecules, evaluates the role of reactive vs proactive TDM, and identifies the gaps in current evidence. In the future, adaptations to how we use TDM may contribute further to the goal of personalized treatment in patients with IBD.

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