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Personalized Minimal Effective Concentration Therapy.

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  • 1Department of Clinical Pharmacology, University Medical School Goettingen, Hannover, Germany.

Clinical Therapeutics
|October 14, 2023
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Summary
This summary is machine-generated.

Therapeutic drug management (TDM) personalizes medication dosing for better patient outcomes. While TR-guided TDM has benefits, novel methods using DNA are emerging for specific drugs like immunosuppressants and anticancer agents.

Keywords:
ImmunosuppressantsLiquid biopsyMinimal effective concentrationsOncologyPersonalized therapy

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Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Biotechnology

Background:

  • Individualized medication dosing is a long-standing clinical goal.
  • Therapeutic drug management (TDM) uses drug concentration measurements to personalize dosing.
  • Challenges in TDM implementation have limited its widespread adoption.

Purpose of the Study:

  • To discuss the benefits and limitations of target range (TR)-guided TDM.
  • To explore alternative methods for individualizing drug doses.
  • To highlight specific drug classes where TDM requires adapted approaches.

Main Methods:

  • Review of analytical and mathematical methods for drug concentration measurement and prediction.
  • Analysis of clinical practices in TDM for various patient populations.
  • Examination of novel biomarkers for dose individualization.

Main Results:

  • TDM enables optimization of drug efficacy and toxicity by adjusting doses to achieve therapeutic ranges (TRs).
  • Limitations in TDM execution have hindered its acceptance.
  • Emerging strategies utilize circulating tumor or graft DNA for dose adjustment in specific cases.

Conclusions:

  • TDM is crucial for effective and safe medication management.
  • Clinicians must adapt prescribing practices for drugs like immunosuppressants and anticancer agents.
  • Novel biomarkers offer promising alternatives to traditional TRs for personalized dosing.