Therapeutic drug monitoring (TDM) is a valuable tool that aids clinical decision making, but there is some controversy over its pre-emptive use for monitoring disease progression. Professor Jimmy Limdi discusses current approaches to TDM in clinical practice.
The pharmacological management of inflammatory bowel disease (IBD) has advanced dramatically in the last decade to include biological agents. However, many patients never respond to these therapies, and even more develop loss of response (LOR) over time. Therapeutic drug monitoring (TDM) is a valuable tool that aids clinical decision making, but there is some controversy over its pre-emptive use for monitoring disease progression. Professor Jimmy Limdi discusses current approaches to TDM in clinical practice.
Inflammatory bowel disease (IBD) is a group of chronic, relapsing and remitting, progressive and potentially disabling immune-mediated conditions – comprising of ulcerative colitis (UC) and Crohn’s disease (CD) – causing chronic inflammation affecting the gastro-intestinal tract.1,2 In the UK, these conditions affect approximately 300,000 people, a prevalence equating to 1 in every 210 individuals, with wide-reaching implications. Of this affected population, around 5,000 IBD patients fall under the care of the Northern Care Alliance NHS Foundation Trust, one of the largest IBD service providers in the country. The Trust consists of four hospitals and extensive community services within Bury, Rochdale, Salford and Oldham, and is considered a tertiary unit for IBD – attracting many complex referrals – as well as one of the top five centres for clinical trials in England.
Understanding intestinal inflammation
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