Checking blood levels of commonly used disease-modifying anti-rheumatic drugs (DMARDs) has gained widespread attention in the rheumatology community, even resulting in a recent guidance document from EULAR for biologics.1 Although a highly useful tool, drug level measurement in rheumatology is not without challenges; many of our drugs violate the basic principles of pharmacology that we…
Although rheumatologists prescribe tumor necrosis factor inhibitors (TNFi’s) to treat several rheumatic diseases, they recognize immunogenicity influences the efficacy and safety of TNFi’s. Example: The formation of anti-drug antibodies can affect infusion reactions and cause low-serum drug levels and therapeutic failure. The induction phase is a period of high incidence of immunogenicity, and observational data…
NEW YORK (Reuters Health)—Results of a randomized controlled trial do not support routine use of proactive therapeutic drug monitoring (TDM) during infliximab induction for improving disease remission rates in patients rheumatoid arthritis (RA) and other chronic immune-mediated inflammatory diseases. Proactive therapeutic drug monitoring tailors biologic therapy to individual patients by measuring serum drug levels and…