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Commentary
Putting TDM knowledge into practice
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  1. Alan C Moss
  1. Department of Gastroenterology, BIDMC/Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Alan C Moss, Department of Gastroenterology, BIDMC/Harvard Medical School, Boston, MA 02215, USA; amoss{at}bidmc.harvard.edu

https://doi.org/10.1136/flgastro-2018-101159

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    ‘Knowledge is of no value unless you put it into practice’ is a quote usually attributed to Anton Chekov. It is advice particularly relevant to therapeutic drug monitoring (TDM) of infliximab (IFX) in patients with inflammatory bowel disease (IBD). Several observational studies have identified low IFX trough levels, or antibodies to IFX, or both, as a factor in the loss of response to this drug in patients with IBD.1 In addition, intervention studies to prospectively adjust IFX dosing to maintain a range of trough levels have shown some impact on long-term outcomes (IBD).2 Collectively, these data implied that using TDM routinely in the clinic could improve outcomes, and minimise risk of adverse events, for patients. Whether this assumption is correct can only be answered with longitudinal studies from the ‘real world’. Recent guidelines have recommended …

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