Therapeutic Drug Monitoring in Pediatric IBD: Current Application and Future Perspectives

Area of Science:

• Gastroenterology and Hepatology
• Pharmacology and Pharmaceutical Sciences
• Pediatric Medicine

Background:

• Inflammatory bowel disease (IBD) management is shifting towards complete deep remission, necessitating personalized medicine.
• Therapeutic drug monitoring (TDM) is a key component of personalized medicine, with expanding applications in IBD patient care.

Purpose of the Study:

• To review the rationale and evidence supporting TDM in IBD.
• To examine the current and future role of TDM in managing pediatric IBD.

Main Methods:

• Literature review of existing studies and clinical data.

Main Results:

• TDM, initially used with thiopurines and anti-TNF therapies, has evolved significantly.
• TDM strategies are cost-effective for patients with loss of response to biologics.
• Proactive TDM optimizes drug exposure, reducing treatment failure and adverse events.
• Ongoing research explores TDM with new biologics and software tools for dosing guidance.

Conclusions:

• Therapeutic drug monitoring (TDM) is integral to modern IBD management.
• TDM maximizes the cost-benefit ratio of IBD therapies.
• Personalized medicine approaches, including TDM, are essential for improving IBD outcomes.