Y Gofin et al. Inflamm Bowel Dis 2020; 26: 1276-82.  Therapeutic Drug Monitoring Increases Drug Retention of Anti–Tumor Necrosis Factor Alpha Agents in Pediatric Patients With Crohn’s Disease

Retrospective study with 197 pediatric participants (2007-2018)

Key findings:

• Compared with the TDM- group (n=98), the TDM+ group (n=99)
  • longer drug retention time (mean ± SE, 45.0 ± 2.7 vs 33.5 ± 2.4 months; P = 0.001)
  • lower hospitalization rate per patient per year (mean ± SE, 0.51 ± 0.7 vs 0.92 ± 0.81; P < 0.001)
  • higher treatment intensification rate (70% vs 18%; P < 0.001).
• Analysis of the entire cohort showed a longer retention time for adalimumab vs infliximab (45.3 ± 2.8 vs 34.8 ± 2.5 months; P = 0.007)

My take: This is another study showing utility of proactive therapeutic drug monitoring

Related blog posts:

• Here’s the Proof That Proactive Therapeutic Drug Monitoring Improves Outcomes in Children with Crohn’s Disease
• CCFA 2019 Update: Proactive Therapeutic Drug Monitoring
• Appropriate Proactive Therapeutic Drug Monitoring
• Briefly noted: Induction Infliximab Levels
• Is there good evidence for proactive therapeutic drug monitoring of anti-TNF therapy?
• Is Standard Infliximab Dose Too Low in Pediatrics?
• Can Therapeutic Drug Monitoring with Monotherapy Achieve Similar Results as Combination Therapy for IBD? | gutsandgrowth

• AGA 2017 Guidelines on Therapeutic Monitoriing Proactive drug monitoring: “careful and selective use of proactive TDM could be beneficial, but current evidence for its routine use is limited and its overall benefits remain uncertain”
• “Silent” Crohn’s Disease | gutsandgrowth
• Treating to Target | gutsandgrowth
• New Target Drug Levels in Inflammatory Bowel Disease | gutsandgrowth