Vedolizumab trough level monitoring in inflammatory bowel disease: a state-of-the-art overview.
Crohn’s disease
Inflammatory bowel disease
Therapeutic drug monitoring
Ulcerative colitis
Vedolizumab
Journal
BMC medicine
ISSN: 1741-7015
Titre abrégé: BMC Med
Pays: England
ID NLM: 101190723
Informations de publication
Date de publication:
08 05 2019
08 05 2019
Historique:
received:
07
01
2019
accepted:
11
04
2019
entrez:
9
5
2019
pubmed:
9
5
2019
medline:
20
11
2019
Statut:
epublish
Résumé
Therapeutic drug monitoring involves therapeutic modifications based on the measurement of drug levels and antidrug antibodies. The viability of therapeutic drug monitoring in vedolizumab-treated patients with inflammatory bowel disease remains questioned. Accumulating evidence from clinical trials and real-world data suggests that an exposure-efficacy relationship may exist for vedolizumab in inflammatory bowel disease, but results are not as straightforward as they are for anti-tumour necrosis factor-α therapy. Robust target vedolizumab trough levels are currently missing, since available data are heterogenous and prospective, interventional pharmacokinetic-pharmacodynamic studies are lacking. The positioning of vedolizumab drug monitoring in therapeutic algorithms is yet to be defined. Therapeutic drug monitoring has the potential to improve the outcome parameters of vedolizumab-treated patients with inflammatory bowel disease. Before the therapeutic drug monitoring of vedolizumab can be implemented in a widespread fashion, prospective studies are needed to evaluate the effect of vedolizumab dose optimisation. These studies should focus on objective disease markers and vedolizumab drug levels, and define thresholds for optimal drug exposure.
Sections du résumé
BACKGROUND
Therapeutic drug monitoring involves therapeutic modifications based on the measurement of drug levels and antidrug antibodies. The viability of therapeutic drug monitoring in vedolizumab-treated patients with inflammatory bowel disease remains questioned.
MAIN BODY
Accumulating evidence from clinical trials and real-world data suggests that an exposure-efficacy relationship may exist for vedolizumab in inflammatory bowel disease, but results are not as straightforward as they are for anti-tumour necrosis factor-α therapy. Robust target vedolizumab trough levels are currently missing, since available data are heterogenous and prospective, interventional pharmacokinetic-pharmacodynamic studies are lacking. The positioning of vedolizumab drug monitoring in therapeutic algorithms is yet to be defined.
CONCLUSION
Therapeutic drug monitoring has the potential to improve the outcome parameters of vedolizumab-treated patients with inflammatory bowel disease. Before the therapeutic drug monitoring of vedolizumab can be implemented in a widespread fashion, prospective studies are needed to evaluate the effect of vedolizumab dose optimisation. These studies should focus on objective disease markers and vedolizumab drug levels, and define thresholds for optimal drug exposure.
Identifiants
pubmed: 31064370
doi: 10.1186/s12916-019-1323-8
pii: 10.1186/s12916-019-1323-8
pmc: PMC6505179
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
vedolizumab
9RV78Q2002
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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