Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 21, 2022; 28(15): 1604-1607
Published online Apr 21, 2022. doi: 10.3748/wjg.v28.i15.1604
Therapeutic drug monitoring in inflammatory bowel disease treatments
Meng-Yao Wang, Jing-Wen Zhao, Chang-Qing Zheng, Li-Xuan Sang
Meng-Yao Wang, Jing-Wen Zhao, Chang-Qing Zheng, Li-Xuan Sang, Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang 110022, Liaoning Province, China
Author contributions: Wang MY and Zhao JW wrote the letter; Sang LX and Zheng CQ supervised the manuscript drafting; each author contributed important intellectual content during manuscript drafting and revision.
Conflict-of-interest statement: Nothing to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Xuan Sang, MD, PhD, Associate Professor, Department of Gastroenterology, Shengjing Hospital of China Medical University, No. 39 Gliding Road, Tiexi District, Shenyang 110022, Liaoning Province, China. sanglixuan2008@163.com
Received: October 21, 2021
Peer-review started: October 21, 2021
First decision: December 27, 2021
Revised: January 6, 2022
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: April 21, 2022
Processing time: 175 Days and 20.5 Hours
Abstract

Recently, biological drugs have played a leading role in the treatment of inflammatory bowel disease, and therapeutic drug monitoring (TDM) may be useful in maximizing their effectiveness. TDM involves the measurement of serum drug and anti-drug antibodies concentrations as the basis for dosage adjustments or drug conversions to achieve a higher response rate. We believe that concentration thresholds should be individualized based on patients’ disease severity, extent and phenotype, and therapeutic purposes should also be considered, with higher cut-offs mainly needed for endoscopic and fistula healing than for symptomatic remission. Proactive and reactive TDM can help optimize treatment, especially in patients receiving anti-tumour necrosis factor, and guide dose adjustment or drug conversion with lower cost. TDM is a promising approach to achieve precision medicine and targeted medicine in the future.

Keywords: Therapeutic drug monitoring; Inflammatory bowel disease; Biologic therapies; Reactive; Proactive; Cost-effective

Core Tip: Therapeutic drug monitoring (TDM) has proven to be useful in the management of patients with inflammatory bowel disease (IBD). The therapeutic value, feasibility and application prospect of TDM in the treatment of IBD were discussed.