Title :

Therapeutic Drug Monitoring (TDM) in IBD

Category :

Anti-TNFs, Biologics, Therapeutic drug monitoring

Drug :

Anti-TNF therapy
  • 43 year old with Crohn’s disease on adalimumab/Humira but now has developed a loss of response.
  • Low trough level and elevated antibody: what is next?
    • Who checks levels and when do you check levels? We need to understand that ‘one size doesn’t fit all’ and therefore TDM should be routinely practiced.
    • Which assay do you typically use? This depends on your institution, patient’s insurance and costs.
    • How do you interpret the drug and antibody levels?
    • Low drug level, low/undetectable antibodies -> dose escalate anti TNF
    • Normal drug level, detectable antibodies -> maximize anti-TNF efficacy, consider IMM; consider switch to another anti-TNF or out of class biologic
    • Normal drug level, low/undetectable antibodies -> evaluate for active disease, scope, imaging
    • When do you consider combination therapy with an immunomodulator and biologic agent? Based on clinical symptoms, severity of symptoms, age, predictors of severe disease, response to treatment
    • Who has used the newer assays – vedolizumab, certolizumab? Newer assays are now available

Consensus: TDM is an important clinical practice for IBD management of response to treatment and consideration of change in treatment. One dose isn’t for all.

REGISTER
 
Waitlist Registeration
 
 
My Registration
Welcome
Welcome to the registration Module
Enter your email:
My Registration
Welcome
You are already registered for this meeting
Select another meeting or Exit
Select your meeting
My Registration
Welcome
Enter Invitation code for Dialogue
    or     Request
My Registration
Welcome
Please fill below information to request invitation code.
Loading...