Advantages of Proactive Therapeutic Drug Monitoring in a Prospective Cohort of Children With Inflammatory Bowel Disease Treated With Anti-Tumour Necrosis Factor

ABSTRACT Few studies have addressed whether proactive therapeutic drug monitoring (TDM) results in improved clinical outcomes in children with inflammatory bowel disease (IBD) treated with anti-tumour necrosis factor. The aim of this study was to investigate the impact of using proactive TDM in this patient group. Pilot single-centre observational study to accrue data on patients managed with proactive TDM. More patients in the proactive TDM cohort were managed by escalating the infliximab (IFX) regime (P < 0.001). The need for switching to different biologics was significantly lower in this patient group (P < 0.001). The introduction of proactive TDM resulted in a significant reduction of patients requiring switch of their primary biologic. The results of this study are indicators that proactive TDM offers a better method of managing children with IBD on IFX therapy.

[1]  R. Battat,et al.  Is Proactive Therapeutic Drug Monitoring Ready for the Spotlight in Inflammatory Bowel Disease? Follow the Data. , 2021, The American journal of gastroenterology.

[2]  M. Dubinsky,et al.  A Comprehensive Literature Review and Expert Consensus Statement on Therapeutic Drug Monitoring of Biologics in Inflammatory Bowel Disease , 2021, The American journal of gastroenterology.

[3]  H. Peeters,et al.  Ultra-proactive therapeutic drug monitoring of infliximab based on point-of-care-testing in inflammatory bowel disease: results of a pragmatic trial. , 2021, Journal of Crohn's & colitis.

[4]  Inge Christoffer Olsen,et al.  Effect of Therapeutic Drug Monitoring vs Standard Therapy During Infliximab Induction on Disease Remission in Patients With Chronic Immune-Mediated Inflammatory Diseases: A Randomized Clinical Trial. , 2021, JAMA.

[5]  J. Feuerstein,et al.  Highs and Lows of Proactive Therapeutic Drug Monitoring in Crohn’s Patients , 2021, Digestive Diseases and Sciences.

[6]  A. Ananthakrishnan,et al.  Infliximab Trough Levels Are Not Predictive of Relapse in Patients with IBD in Endoscopic Remission: A Multicenter Cohort Study , 2020, Digestive Diseases and Sciences.

[7]  A. Griffiths,et al.  The Medical Management of Paediatric Crohn's Disease: an ECCO-ESPGHAN Guideline Update. , 2020, Journal of Crohn's & colitis.

[8]  L. Stassen,et al.  ECCO Guidelines on Therapeutics in Crohn's Disease: medical treatment. , 2019, Journal of Crohn's & colitis.

[9]  B. Weiss,et al.  Proactive Monitoring of Adalimumab Trough Concentration Associated With Increased Clinical Remission in Children with Crohn's Disease Compared with Reactive Monitoring. , 2019, Gastroenterology.

[10]  B. Vaughn,et al.  Proactive therapeutic drug monitoring of adalimumab is associated with better long-term outcomes compared to standard of care in patients with inflammatory bowel disease. , 2019, Journal of Crohn's & colitis.

[11]  M. Parkes,et al.  Predictors of anti-TNF treatment failure in anti-TNF-naive patients with active luminal Crohn's disease: a prospective, multicentre, cohort study. , 2019, The lancet. Gastroenterology & hepatology.

[12]  A. Griffiths,et al.  Clinical Outcomes With Therapeutic Drug Monitoring in Inflammatory Bowel Disease: A Systematic Review With Meta-Analysis , 2018, Journal of Crohn's & colitis.

[13]  A. Gasbarrini,et al.  Therapeutic Drug Monitoring is More Cost-Effective than a Clinically Based Approach in the Management of Loss of Response to Infliximab in Inflammatory Bowel Disease: An Observational Multicentre Study , 2018, Journal of Crohn's & colitis.

[14]  Ravy K. Vajravelu,et al.  Improved Long‐term Outcomes of Patients With Inflammatory Bowel Disease Receiving Proactive Compared With Reactive Monitoring of Serum Concentrations of Infliximab , 2017, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[15]  Siddharth Singh,et al.  American Gastroenterological Association Institute Guideline on Therapeutic Drug Monitoring in Inflammatory Bowel Disease. , 2017, Gastroenterology.

[16]  M. Silverberg,et al.  Therapeutic Drug Monitoring to Guide Infliximab Dose Adjustment is Associated with Better Endoscopic Outcomes than Clinical Decision Making Alone in Active Inflammatory Bowel Disease , 2017, Inflammatory bowel diseases.

[17]  K. Van Steen,et al.  Trough concentrations of infliximab guide dosing for patients with inflammatory bowel disease. , 2015, Gastroenterology.

[18]  W. Sandborn,et al.  Proactive Therapeutic Concentration Monitoring of Infliximab May Improve Outcomes for Patients with Inflammatory Bowel Disease: Results from a Pilot Observational Study , 2014, Inflammatory bowel diseases.

[19]  L. A. Christensen,et al.  Individualised therapy is more cost-effective than dose intensification in patients with Crohn’s disease who lose response to anti-TNF treatment: a randomised, controlled trial , 2013, Gut.