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Review
. 2022 Feb;88(4):1406-1413.
doi: 10.1111/bcp.14434. Epub 2020 Jul 1.

TDM is dead. Long live TCI!

Nick Holford  1 , Guangda Ma  1 , David Metz  2
Affiliations
Review

TDM is dead. Long live TCI!

Nick Holford et al. Br J Clin Pharmacol. 2022 Feb.

Abstract

Twenty years ago, target concentration intervention (TCI) was distinguished from therapeutic drug monitoring (TDM). It was proposed that TCI would bring more clinical benefit because of the precision of the approach and the ability to link TCI to principles of pharmacokinetics and pharmacodynamics to predict the dose required by an individual (1). We examine the theory and clinical trial evidence supporting the benefits of TCI over TDM and conclude that in the digital age TDM should be abandoned and replaced by TCI.

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Conflict of interest statement

There are no competing interests to declare.

References

    1. Holford NH. Target concentration intervention: beyond Y2K. Br J Clin Pharmacol. 1999;48(1):9‐13. - PMC - PubMed
    1. Wikipedia . Therapeutic drug monitoring available at https://en.wikipedia.org/wiki/Therapeutic_drug_monitoring. . 2020a.
    1. Wikipedia . Therapeutic window available at https://en.wikipedia.org/wiki/Therapeutic_index#Therapeutic_window. . 2020b.
    1. IATDMCT . https://www.iatdmct.org/. . 2020.
    1. IATDMCT . https://www.iatdmct.org/about-us/about-association/about-definitions-tdm.... . 2011.