title: Current Practice for Therapeutic Drug Monitoring of Biopharmaceuticals in Spondyloarthritis.
abstract: Treatment of spondyloarthritis (SpA) has greatly improved in the biopharmaceutical era. These compounds, primarily tumor necrosis factor inhibitors, are effective, but some patients may show poor response, sometimes due to the presence of antidrug antibodies (ADAs). In some instances, clinicians may increase or taper the dose, depending on the clinical response. Besides the current clinical practice, a tailored strategy based on drug monitoring is emerging as a way to improve the use of these drugs. However, the relevance of this therapeutic drug monitoring of biopharmaceuticals for SpA is still unknown. In this literature review, we examined the most relevant articles dealing with the concentration-response relation, ADA detection, and pharmacokinetics in SpA treated with biopharmaceuticals. ADAs were associated with low or undetectable concentration of monoclonal antibodies. The relation between drug concentration and clinical response in SpA is debated, some studies showing an association and others not. Therefore, therapeutic drug monitoring of biopharmaceuticals for SpA requires a better understanding of the association among the pharmacokinetics, pharmacodynamics, and immunogenicity of these drugs.
authors.affiliation: *Rheumatology Department and Pharmacology-Toxicology Laboratory, Université François-Rabelais de Tours, CNRS, UMR 7292, Tours, France; and †Rheumatology Department and Health Research Institute (Idipaz), Hospital Universitario de La Paz, Madrid, Spain.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Medina
authors.forename: Chamaida
authors.initials: C
authors.lastname: Plasencia
authors.forename: Philippe
authors.initials: P
authors.lastname: Goupille
authors.forename: Gilles
authors.initials: G
authors.lastname: Paintaud
authors.forename: Alejandro
authors.initials: A
authors.lastname: Balsa
authors.forename: Denis
authors.initials: D
authors.lastname: Mulleman
mesh_terms: D000818:Animals; D001688:Biological Products / Q000097:blood* / Q000627:therapeutic use*; D001702:Biopharmaceutics / Q000379:methods / Q000639:trends; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods* / Q000639:trends; D006801:Humans; D013167:Spondylitis, Ankylosing / Q000097:blood* / Q000188:drug therapy*
chemical_list: D001688:Biological Products