Curr Gastroenterol Rep. 2022 Dec;24(12):191-200.doi: 10.1007/s11894-022-00854-5. Epub 2022 Dec 2.

Bryant W Megna ¹, Byron P Vaughn ^2 3

Author information

¹Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN, USA. megna003@umn.edu.

²Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN, USA.

³Inflammatory Bowel Disease Program, University of Minnesota, Minneapolis, MN, USA.

Abstract

Purpose of review: To outline the development, rationale, and practical use of therapeutic drug monitoring in patients with inflammatory bowel disease.

Recent findings: Therapeutic drug monitoring is traditionally discussed in terms of a proactive or reactive approach. However, these terms are not always consistently defined and can be confusing when translating research to clinical practice. Personalized approaches incorporating clinical context and precision medicine are emerging. Personalized therapeutic drug monitoring combines a structured and proactive strategy for monitoring biologic concentrations as well as identification of antidrug antibody development or subtherapeutic dosing in the setting of loss of response. Optimizing biologic therapy can improve outcomes and avoid loss of response. Why, when, and how we measure drug troughs and anti-drug antibodies is a moving target, though what is known is that the appropriate and evidence-based use of this practice prevents adverse events and improves outcomes in patients with inflammatory bowel disease.