Update on TDM (Therapeutic Drug Monitoring) with Ustekinumab, Vedolizumab and Tofacitinib in Inflammatory Bowel Disease

The goal of therapeutic drug monitoring (TDM) is to optimize anti-TNF (tumor necrosis factor) biologic treatment in patients with inflammatory bowel disease (IBD). Although commercial assays are readily available for both ustekinumab and vedolizumab, the use of TDM with these newer biologic medications is at its infancy. The clinical utility of TDM with non-anti-TNF mechanisms of action is not clear. This review summarizes the latest available data on the pharmacokinetics of newer biologic and oral small molecules and highlights the threshold concentrations that have been associated with improved outcomes in IBD patients.

Automated summary

The aim of TDM is to optimize the treatment of IBD patients with biologic agents, particularly newer agents like ustekinumab and vedolizumab. The use of TDM with these newer agents is still in its infancy, and the clinical utility of TDM with non-anti-TNF mechanisms of action remains unclear. This review summarizes the latest pharmacokinetic data on newer biologics and oral small molecules, emphasizing the threshold concentrations associated with improved outcomes in IBD patients.