Etiology and Management of Lack or Loss of Response to Anti-Tumor Necrosis Factor Therapy in Patients With Inflammatory Bowel Disease.

Primary nonresponse antidrug antibody secondary loss of response therapeutic drug monitoring

Journal

Gastroenterology & hepatology
ISSN: 1554-7914
Titre abrégé: Gastroenterol Hepatol (N Y)
Pays: United States
ID NLM: 101262648

Informations de publication

Date de publication:
Dec 2019
Historique:
entrez: 2 1 2020
pubmed: 2 1 2020
medline: 2 1 2020
Statut: ppublish

Résumé

The management of patients with moderate to severe inflammatory bowel disease was transformed with the arrival of anti-tumor necrosis factor (TNF) therapy. Nevertheless, a considerable number of patients do not respond to anti-TNF induction therapy (primary nonresponse) or lose response to treatment over time after initially experiencing clinical improvement (secondary loss of response). Studies suggest that these outcomes are often due to inadequate drug concentrations. Therapeutic drug monitoring (TDM) is a practical tool that can be used to better define the etiologies of and help manage primary nonresponse or secondary loss of response. Proactive TDM, or drug titration to a target trough concentration, can improve the efficacy of anti-TNF treatment and lead to favorable clinical outcomes. However, in patients with adequate anti-TNF drug concentrations and active disease, alternate pathways of inflammation (not driven by TNFa agents) are at play, and therapies with another mechanism of action should be employed.

Identifiants

PMID: 31892912 PMC: PMC6935028
pubmed: 31892912
pmc: PMC6935028

Types de publication

Journal Article

Langues

eng

Pagination

656-665

Subventions

Organisme : NIDDK NIH HHS
ID : T32 DK007760
Pays : United States

Informations de copyright

Copyright © 2019, Gastro-Hep Communications, Inc.

Déclaration de conflit d'intérêts

Dr Cheifetz has received consultancy fees from Janssen, AbbVie, Takeda, Pfizer, Samsung, Arena Pharmaceuticals, Bacainn Therapeutics, EMD Serono, Arsanis, Grifols, and Prometheus, and has received research support from Inform Diagnostics. Dr Fine is on the speaking bureau for AbbVie. Dr Papamichael has received a lecture fee from Mitsubishi Tanabe Pharma.

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Auteurs

Sean Fine (S)

Dr Fine is director of the Center for Inflammatory Bowel Disease at Brown Medicine at the Warren Alpert Medical School of Brown University in Providence, Rhode Island. Dr Papamichael is a research fellow in the Division of Gastroenterology at Beth-Israel Deaconess Medical Center in Boston, Massachusetts. Dr Cheifetz is director of the Center for Inflammatory Bowel Diseases at Beth-Israel Deaconess Medical Center.

Kostantinos Papamichael (K)

Dr Fine is director of the Center for Inflammatory Bowel Disease at Brown Medicine at the Warren Alpert Medical School of Brown University in Providence, Rhode Island. Dr Papamichael is a research fellow in the Division of Gastroenterology at Beth-Israel Deaconess Medical Center in Boston, Massachusetts. Dr Cheifetz is director of the Center for Inflammatory Bowel Diseases at Beth-Israel Deaconess Medical Center.

Adam S Cheifetz (AS)

Dr Fine is director of the Center for Inflammatory Bowel Disease at Brown Medicine at the Warren Alpert Medical School of Brown University in Providence, Rhode Island. Dr Papamichael is a research fellow in the Division of Gastroenterology at Beth-Israel Deaconess Medical Center in Boston, Massachusetts. Dr Cheifetz is director of the Center for Inflammatory Bowel Diseases at Beth-Israel Deaconess Medical Center.

Classifications MeSH