IBD Therapy: 5 Reasons for Using Drug Monitoring

The burden of inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is increasing worldwide.

With the development of anti-tumour necrosis factor (antiTNF) drugs it became possible to significantly improve inflammatory bowel diseases (IBD) outcomes.  These monoclonal antibodies revolutionised the management of moderate to severe Crohn’s disease (CD) and ulcerative colitis (UC).  However, the risk of treatment failure and side effects, require careful monitoring of these drugs.  Monitoring medication levels during treatment, benefit more than just the patient.

1. Better efficacy

Therapeutic drug monitoring (TDM), regularly measures the concentration of the active ingredient in the patient’s blood and the dosage is adjusted as needed.  Monitoring is important because every person metabolizes medication differently due to individual pharmacokinetics, whereby different drug levels can be present even though the dose is identical.  Every drug has its optimum effect within a certain concentration range called the therapeutic window.  By measuring the drug levels, treatment providers can offer personalized therapy that ensures the drug dosage is correct and the medication is working optimally.

2. Fewer side effects

If the drug level is too low, the medication will not work optimally.  However, if a drug level is too high it is also problematic, since it can cause side effects or even toxic effects.  With TDM you can avoid or manage side effects.

3. Long-term therapy success

In some patients with chronic IBD, the drug starts to lose its effect over time, which can require changing the medication.  One reason for the loss of efficacy may be that the dosage is too low and the body developed antibodies against the drug (anti-drug antibodies, ADA).  Monitoring of the drug and ADA concentrations help treatment providers adapt the therapy to the patient’s individual needs and ensure long-term therapy success.

4. Better quality of life

Long-acting therapy at optimal levels with fewer side effects has a long-lasting improvement in the patient’s quality of life.

5. Cost savings

If the patient receives a dosage that is too high, the patient takes unnecessary medication with cost implications.  Studies showed that TDM has a positive effect on reducing treatment costs.