Therapeutic drug monitoring of biologics in inflammatory bowel disease: unmet needs and future perspectives.

Abstract	Therapeutic drug monitoring (TDM) has emerged as a useful tool for optimising the use of biologics, and in particular anti-tumour necrosis factor (anti-TNF) therapy, in inflammatory bowel disease (IBD). However, challenges remain and are hindering the widespread implementation of TDM in clinical practice. These barriers include identification of the optimal drug concentration to target, the lag time between sampling and results, and the proper interpretation of anti-drug antibody titres among different assays. Solutions to overcome these barriers include the harmonisation of TDM assays and the use of point-of-care testing. Other unmet needs include well designed prospective studies and randomised controlled trials focusing on proactive TDM, particularly during induction therapy. Future studies should also investigate the utility of TDM for biologics other than anti-TNF therapies in both IBD and other immune-mediated inflammatory diseases such as rheumatoid arthritis and psoriasis, and the use of pharmacokinetic modelling dashboards and pharmacogenetics towards individual personalised medicine.
Authors	Konstantinos Papamichael, Waqqas Afif, David Drobne, Marla C Dubinsky, Marc Ferrante, Peter M Irving, Nikolaos Kamperidis, Taku Kobayashi, Paulo G Kotze, Jo Lambert, Nurulamin M Noor, Xavier Roblin, Giulia Roda, Niels Vande Casteele, Andres J Yarur, Naila Arebi, Silvio Danese, Stephane Paul, William J Sandborn, Séverine Vermeire, Adam S Cheifetz, Laurent Peyrin-Biroulet, International Consortium for Therapeutic Drug Monitoring
Journal	The lancet. Gastroenterology & hepatology (Lancet Gastroenterol Hepatol) Vol. 7 Issue 2 Pg. 171-185 (02 2022) ISSN: 2468-1253 [Electronic] Netherlands
PMID	35026171 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)
Copyright	Copyright © 2022 Elsevier Ltd. All rights reserved.
Chemical References	Biological Products
Topics	Biological Products (adverse effects, therapeutic use) Drug Monitoring (trends) Forecasting Humans Inflammatory Bowel Diseases (drug therapy)

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