title: Could therapeutic drug monitoring of anti-TNF-α be useful to consider a de-escalation of treatment?
abstract: In recent years, many retrospective studies have demonstrated the interest of therapeutic anti-TNF drug monitoring in inflammatory bowel disease. This could be especially helpful in two different situations: a secondary loss of anti-TNF response where a re-elevation of drug levels by treatment optimization is predictive of better clinical outcome; a therapeutic de-escalation or discontinuation for Crohn's disease patients in long-standing remission where an undetectable anti-TNF drug level could be predictive of clinical remission.
authors.affiliation: a 1 Gastroenetrology Unit, University of Nantes , Nantes, France.
authors.forename: Mathurin
authors.initials: M
authors.lastname: Flamant
authors.affiliation: b 2 Gastroenterology unit , University of Saint Etienne , Saint Etienne, France xavier.roblin@chu-st-etienne.fr.
authors.forename: Xavier
authors.initials: X
authors.lastname: Roblin
mesh_terms: D001379:Azathioprine / Q000378:metabolism / Q000627:therapeutic use; D016903:Drug Monitoring; D006801:Humans; D007155:Immunologic Factors / Q000378:metabolism / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy; D000069285:Infliximab / Q000378:metabolism* / Q000627:therapeutic use; D012008:Recurrence; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
chemical_list: D007155:Immunologic Factors; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D001379:Azathioprine
keywords: anti-TNF; de-escalation; inflammatory bowel disease; trough levels