title: Drug monitoring of biologics in inflammatory bowel disease.
abstract: OBJECTIVE
  The monoclonal antibodies currently used for the treatment of inflammatory bowel disease (IBD) have been thoroughly studied with regard to efficacy and safety. Their pharmacokinetics and the considerable inter-individual variability of clearance and immunogenicity have attracted a great deal of attention recently. Knowledge about their properties carries the potential to optimize efficacy and durability of therapeutics that is a mainstay in the medical management of IBD.
  
  
  RESULTS
  Based on population-based pharmacokinetics models, factors impacting the clearance of infliximab have been identified, antidrug antibodies (ADA) being one of them. Trough levels have been shown to correlate with clinical response and steroid-free remission. Initial insights have recently been gained into the individual course of ADA with a potential impact on future therapeutic strategies.
  
  
  CONCLUSIONS
  We briefly review the current state of the literature and propose an algorithm for the use of serum trough levels and ADA as basis for monitoring of biologics in patients with IBD.
authors.affiliation: Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Eser
authors.forename: Christian
authors.initials: C
authors.lastname: Primas
authors.forename: Walter
authors.initials: W
authors.lastname: Reinisch
mesh_terms: D000465:Algorithms; D000911:Antibodies, Monoclonal / Q000097:blood / Q000276:immunology / Q000627:therapeutic use; D000917:Antibody Formation; D001688:Biological Products / Q000097:blood / Q000276:immunology / Q000627:therapeutic use*; D016903:Drug Monitoring / Q000379:methods*; D005765:Gastrointestinal Agents / Q000097:blood / Q000276:immunology / Q000627:therapeutic use; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D000069285:Infliximab; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D001688:Biological Products; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab