摘要
背景:随着IBD管理的范式从症状控制演变为更加雄心勃勃的完全深度缓解目标,个性化医疗的概念,作为提供具有最佳有效性和安全性的个性化治疗的手段,变得至关重要。治疗药物监测(TDM)是个性化医疗的重要组成部分,其在IBD患者管理中的作用正在迅速扩大。 目的:回顾目前的知识,这些知识构成了使用TDM的基本原理,以及基于TDM的方法在儿科IBD管理中的当前和未来作用。 方法:文献综述。 结果:十多年前,TDM的概念已经在IBD领域与硫嘌呤一起被引入,并且围绕抗TNF治疗进化。基于TDM的策略被证明在对生物制剂反应丧失的患者的管理中具有成本效益,并且最近,已经证明,主动TDM优化药物暴露可以减少治疗失败和药物不良事件。目前正在研究TDM与新生物制剂的作用以及指导药物剂量的软件系统支持工具的有用性。 结论:治疗药物监测有可能最大限度地提高治疗的成本效益,并成为IBD管理的重要组成部分。
关键词: 治疗药物监测,个性化医疗,IBD,生物制剂,硫嘌呤。
Current Medicinal Chemistry
Title:Therapeutic Drug Monitoring in Pediatric IBD: Current Application and Future Perspectives
Volume: 25 Issue: 24
关键词: 治疗药物监测,个性化医疗,IBD,生物制剂,硫嘌呤。
摘要: Background: as the paradigm for IBD management is evolving from symptom control to the more ambitious goal of complete deep remission, the concept of personalized medicine, as a mean to deliver individualized treatment with the best effectiveness and safety profile, is becoming paramount. Therapeutic drug monitoring (TDM) is an essential part of personalized medicine and its role in the management of IBD patients is rapidly expanding.
Objective: to review the current knowledge that poses the rationale for the use of TDM, and the present and future role of TDM-based approaches in the management of pediatric IBD.
Method: literature review.
Results: the concept of TDM has been introduced in the field of IBD along with thiopurines, over a decade ago, and evolved around anti-TNF therapies. TDM-based strategies proved to be costeffective in the management of patients with loss of response to biologics and, more recently, proactive TDM to optimize drug exposure has been shown to reduce treatment failure and drug adverse events. The role of TDM with new biologics and the usefulness of software-systems support tools to guide drug dosing are now under investigation.
Conclusion: Therapeutic drug monitoring has the potential to maximize the cost-benefit profile of therapies and is becoming an essential part of IBD management.
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Cite this article as:
Therapeutic Drug Monitoring in Pediatric IBD: Current Application and Future Perspectives, Current Medicinal Chemistry 2018; 25 (24) . https://dx.doi.org/10.2174/0929867324666170911163021
DOI https://dx.doi.org/10.2174/0929867324666170911163021 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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