title: Optimization of anti-TNF therapy in patients with Inflammatory Bowel Disease.
abstract: After the introduction of anti-tumor necrosis factor (anti-TNF) agents, the clinical outcome of patients with Inflammatory Bowel Disease (IBD) has improved significantly. However, use of anti-TNF therapy is complicated by loss of response. In order to maintain remission, adequate serum levels are required. Hence, therapeutic drug monitoring (TDM) is important in order to optimize serum drug levels, especially in patients with loss of response to these agents. Optimization of anti-TNF therapy by applying TDM enables clinicians to regain response to TNF blockers in a significant proportion of patients. It is important to use anti-TNF agents in their most optimal way, since these therapeutic agents are expensive and the medical options after failing anti-TNF therapy are limited. Here, we will discuss how to optimize treatment with anti-TNF agents in IBD patients in order to improve treatment efficacy, prevent anti-drug antibody formation, reduce side effects, discontinue unnecessary treatment and manage costs.
authors.affiliation: a Department of Gastroenterology and Hepatology , Academic Medical Centre , Amsterdam , The Netherlands.
authors.forename: A S
authors.initials: AS
authors.lastname: Strik
authors.affiliation: a Department of Gastroenterology and Hepatology , Academic Medical Centre , Amsterdam , The Netherlands.
authors.forename: S J A
authors.initials: SJ
authors.lastname: Bots
authors.affiliation: a Department of Gastroenterology and Hepatology , Academic Medical Centre , Amsterdam , The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: D'Haens
authors.affiliation: a Department of Gastroenterology and Hepatology , Academic Medical Centre , Amsterdam , The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Löwenberg
mesh_terms: D000917:Antibody Formation / Q000276:immunology; D016903:Drug Monitoring / Q000379:methods; D005765:Gastrointestinal Agents / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha
keywords: Inflammatory bowel disease; adalimumab; anti-tumor necrosis factor antibodies; golimumab; infliximab; loss of response; therapeutic drug monitoring