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
. 2023 Sep;52(3):549-563.
doi: 10.1016/j.gtc.2023.05.002. Epub 2023 Jun 9.

The Role of Therapeutic Drug Monitoring in Children

Alexander Nasr  1 , Phillip Minar  2
Affiliations
Review

The Role of Therapeutic Drug Monitoring in Children

Alexander Nasr et al. Gastroenterol Clin North Am. 2023 Sep.

Abstract

The use of biologic therapies has changed the treatment landscape for children with inflammatory bowel disease. While the novel biologics have improved clinical outcomes, there remains a significant gap in achieving endoscopic remission, prolonged steroid-free remission, and drug durability. Contributing to this gap is the paucity of real-world pharmacokinetic studies in children and a failure to dose optimize therapy during induction. Emerging data from a pediatric clinical trial and several observational studies have shown that the combination of proactive therapeutic drug monitoring and achievement of early therapeutic concentrations is effective in achieving improved outcomes. The next steps will be to leverage these past studies to develop more innovative clinical trials to properly assess the safety and effectiveness of proactive therapeutic drug monitoring in children.

Keywords: Drug concentrations; Inflammatory bowel disease; Pharmacokinetics; Proactive Drug monitoring.

PubMed Disclaimer

References

    1. Dahlhamer JM, Zammitti EP, Ward BW, et al. Prevalence of Inflammatory Bowel Disease Among Adults Aged >/=18 Years - United States, 2015. MMWR Morb Mortal Wkly Rep 2016;65(42):1166–9. - PubMed
    1. Colman RJ, Xiong Y, Mizuno T, et al. Antibodies-to-infliximab accelerate clearance while dose intensification reverses immunogenicity and recaptures clinical response in paediatric Crohn’s disease. Aliment Pharmacol Ther 2022;55(5):593–603. - PMC - PubMed
    1. Cosnes J, Gower-Rousseau C, Seksik P, et al. Epidemiology and natural history of inflammatory bowel diseases. Research Support, Non-U.S. Gov’t. Gastroenterology 2011;140(6):1785–94. - PubMed
    1. Xiong Y, Mizuno T, Colman R, et al. Real-World Infliximab Pharmacokinetic Study Informs an Electronic Health Record-Embedded Dashboard to Guide Precision Dosing in Children with Crohn’s Disease. Clin Pharmacol Ther 2021;109(6):1639–47. - PMC - PubMed
    1. Colombel JF, Narula N, Peyrin-Biroulet L. Management Strategies to Improve Outcomes of Patients With Inflammatory Bowel Diseases. Gastroenterology 2017;152(2):351–361 e5. - PubMed

Publication types