Goals of therapy for inflammatory bowel disease have advanced beyond symptom control to the normalization of
biomarkers of inflammation, and mucosal healing in particular, with the expectation that this will change the natural history
of these diseases. Concurrent with higher treatment expectations has come an expanded therapeutic armamentarium to
achieve these goals, and a greater ability to optimize each therapeutic class to maximize therapeutic benefits and minimize
unnecessary treatment failures. In addition to these advances has come the evolution of therapeutic drug monitoring which is
increasingly being utilized to optimize the use of immunomodulators and biologic therapies in particular. This review will
outline the principals of optimization of the conventional medical therapies available to the clinician today.
Keywords: Aminosalicylates, allopurinol, anti-tumor necrosis factor agents, corticosteroids, thiopurines, thioguanine nucleotides,
therapeutic drug monitoring.
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