Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 May 21;14(4):542-556.
doi: 10.1093/ecco-jcc/jjz162.

Therapeutic Drug Monitoring of Biologics During Induction to Prevent Primary Non-Response

Miles P Sparrow  1 , Konstantinos Papamichael  2 , Mark G Ward  1 , Pauline Riviere  3 , David Laharie  3 , Stephane Paul  4 , Xavier Roblin  5
Affiliations
Review

Therapeutic Drug Monitoring of Biologics During Induction to Prevent Primary Non-Response

Miles P Sparrow et al. J Crohns Colitis. .

Abstract

Biologic therapies have revolutionized the management of inflammatory bowel disease [IBD], but primary and secondary non-responses occur in a significant proportion of patients. Therapeutic drug monitoring [TDM] now has an established role in the treatment algorithm for managing secondary loss of response to anti-tumour necrosis factor [anti-TNF] agents during maintenance therapy. Data to support the use of TDM in the management of secondary loss of response to vedolizumab and ustekinumab are emerging. The potential to prevent primary non-response to biologic agents during induction is of equal, and potentially greater, clinical importance. Again, most data supporting the use of 'proactive' TDM during induction pertains to the use of anti-TNF agents, but signals of efficacy for the use of TDM during induction with other biologic classes are now appearing. This review aims to summarize data on the use of TDM during induction to prevent pharmacokinetic primary non-response to all three classes of biologic therapy currently available for the treatment of IBD.

Keywords: induction; primary non-response; therapeutic drug monitoring.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Potential benefits of TDM of biologic agents during induction. PNR, primary non-response; SLOR, secondary loss of response; QOL, quality of life.
Figure 2.
Figure 2.
Suggested algorithm for induction TDM for anti-TNF agents. IMM, immunomodulator; PNR, primary non-response.
See this image and copyright information in PMC

References

    1. Shah SC, Colombel JF, Sands BE, Narula N. Systematic review with meta-analysis: mucosal healing is associated with improved long-term outcomes in Crohn’s disease. Aliment Pharmacol Ther. 2016;43:317–33. - PubMed
    1. Shah SC, Colombel JF, Sands BE, Narula N. Mucosal healing is associated with improved long-term outcomes of patients with ulcerative colitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2016;14:1245–55 e8. - PubMed
    1. Schnitzler F, Fidder H, Ferrante M, et al. .. Mucosal healing predicts long-term outcome of maintenance therapy with infliximab in Crohn’s disease. Inflamm Bowel Dis 2009;15:1295–301. - PubMed
    1. Colombel JF, Panaccione R, Bossuyt P, et al. .. Effect of tight control management on Crohn’s disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet 2018;390:2779–89. - PubMed
    1. Afif W, Loftus EV Jr, Faubion WA, et al. .. Clinical utility of measuring infliximab and human anti-chimeric antibody concentrations in patients with inflammatory bowel disease. Am J Gastroenterol 2010;105:1133–9. - PMC - PubMed

MeSH terms

Substances