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Anti-TNF drug and antidrug antibody level monitoring in IBD: a practical guide
  1. Philip Hendy1,
  2. Ailsa Hart1,
  3. Peter Irving2
  1. 1IBD Unit, St Mark's Hospital, Harrow, UK
  2. 2Guy's and St Thomas’ IBD Centre, Guy's and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital, London, UK
  1. Correspondence to Dr Philip Hendy, IBD Unit, St Mark's Hospital, Watford Rd, Harrow, HA1 3UJ, UK; philiphendy14{at}


The antitumour necrosis factor (TNF) medications, adalimumab and infliximab, play an important role in the management of both Crohn's disease and ulcerative colitis. For those in whom anti-TNF is effective, the therapy is associated with fewer symptoms, improved quality of life and disease and surgery-free survival. Unfortunately, up to 30% of patients will fail to respond to anti-TNF drugs while up to 50% of those who do see an initial response will lose response at some point. The introduction of drug monitoring for anti-TNFs, including drug level and antidrug antibody level testing allows a more personalised management of patients and improves patient outcomes. This article reviews the data for the use of anti-TNF monitoring and presents a ‘how to’ guide for clinicians.

  • IBD

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