1. Optimization of biologics to reduce treatment failure in inflammatory bowel diseases
- Author
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Anne Breton, Frédérick Barreau, Emmanuel Mas, Cyrielle Gilletta De Saint-Joseph, Aurélie Bourchany, Unité de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, CHU de Toulouse, Département de Gastroentérologie, Hôpital Rangueil, CHU de Toulouse, Institut de Recherche en Santé Digestive (IRSD ), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CCSD, Accord Elsevier, Service Diabétologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Gastroentérologie et pancréatologie [CHU Toulouse], and Pôle Maladies de l'appareil digestif [CHU Toulouse]
- Subjects
0301 basic medicine ,Drug ,medicine.medical_specialty ,media_common.quotation_subject ,Drug Resistance ,Drug resistance ,Antibodies, Monoclonal, Humanized ,030226 pharmacology & pharmacy ,Inflammatory bowel disease ,law.invention ,Efficacy ,03 medical and health sciences ,0302 clinical medicine ,Gastrointestinal Agents ,Randomized controlled trial ,law ,Drug Discovery ,medicine ,Humans ,Treatment Failure ,Intensive care medicine ,media_common ,Pharmacology ,Biological Products ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,medicine.diagnostic_test ,Tumor Necrosis Factor-alpha ,business.industry ,Inflammatory Bowel Diseases ,medicine.disease ,3. Good health ,030104 developmental biology ,Therapeutic drug monitoring ,Monoclonal ,Trough level ,Ustekinumab ,Drug Monitoring ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Moderate to severe inflammatory bowel disease patients can fail to respond to conventional therapy and/or to biologic treatment. In the era of TNFα antagonists and other non-anti-TNF biologic drugs, it is important to review the literature on biologic treatment failure, which could be defined as primary non-response, secondary loss of response and intolerance. Therapeutic drug monitoring (TDM), that is, drug trough level and antidrug antibodies, should enable to determine the mechanisms of treatment failure and to optimize drug efficacy. There is a consensus on reactive TDM at the time of loss of response. Proactive TDM could be of interest during induction and/or maintenance, but randomized controlled trials are required.
- Published
- 2020