title: Pharmacokinetics of anti-TNF monoclonal antibodies in inflammatory bowel disease: Adding value to current practice.
abstract: Since anti-tumor necrosis factor (TNF) antibodies were introduced to treat patients with inflammatory bowel diseases, short- and long-term clinical and endoscopic endpoints can be achieved that were unreachable with conventional anti-inflammatory agents. Although a large proportion of patients (70-90%) initially respond to the treatment, remission rates after induction are still low (20-50%) and patients are at risk to lose response to the drug over time. This inter-individual variability in response is likely to be influenced by the observed inter-individual variability in pharmacokinetics. By extensively reviewing the literature, we evaluated the potential role of therapeutic drug monitoring to optimize dosing of anti-TNF drugs. Thereby we emphasize some of the pharmacokinetic cornerstones that can help to understand the observed concentration-effect relationship. After discussing some of the most commonly used assays to measure anti-TNF drug and anti-drug antibody concentrations, we reviewed the application of those tests and their potential clinical value in retrospective and prospective studies.
authors.affiliation: Department of Pharmaceutical and Pharmacological Sciences, Therapeutic and Diagnostic Antibodies, KU Leuven - University of Leuven, Herestraat, Leuven, Belgium.
authors.forename: Niels
authors.initials: N
authors.lastname: Vande Casteele
authors.forename: Ann
authors.initials: A
authors.lastname: Gils
mesh_terms: D000893:Anti-Inflammatory Agents / Q000097:blood / Q000493:pharmacokinetics*; D000911:Antibodies, Monoclonal / Q000097:blood / Q000493:pharmacokinetics*; D016903:Drug Monitoring; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000378:metabolism; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha
keywords: Crohn's; adalimumab; certolizumab pegol; disease; golimumab; immunogenicity; inflammatory bowel disease; infliximab; personalized medicine; therapeutic drug monitoring; trough level; ulcerative colitis