A value proposition for trough level-based anti-TNFα drug dosing
| Autor: | E. M. H. Schmitz, Maarten A. C. Broeren, D. van de Kerkhof, Luc J J Derijks, Volkher Scharnhorst |
|---|---|
| Přispěvatelé: | Chemical Biology |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Care process Cost effectiveness Clinical Biochemistry Dose-Response Relationship Immunologic Biochemistry Antibodies Dose-Response Relationship 03 medical and health sciences 0302 clinical medicine Immunologic Intervention (counseling) medicine Added value Humans Intensive care medicine Antibodies Monoclonal/immunology medicine.diagnostic_test business.industry Tumor Necrosis Factor-alpha Value proposition Biochemistry (medical) Antibodies Monoclonal General Medicine Tumor Necrosis Factor-alpha/immunology 030104 developmental biology Therapeutic drug monitoring 030220 oncology & carcinogenesis Drug dosing Trough level Female Monoclonal/immunology Drug Monitoring business Drug Monitoring/methods |
| Zdroj: | Clinica Chimica Acta, 489, 89-95. Elsevier |
| ISSN: | 1873-3492 0009-8981 |
| Popis: | Treatment of inflammatory bowel diseases and rheumatic disorders with anti-tumor necrosis factor alpha (TNFα) drugs is expensive, while a significant proportion of patients does not show adequate clinical response. Therapeutic drug monitoring (TDM) enables patient-specific anti-TNFα therapy. The role of laboratory tests in clinical care has recently been described in a value proposition framework. It describes care processes, stakeholders, costs, risks, benefits and patient outcomes based on the use of a laboratory test in a clinical care pathway. We have applied this concept to the use of TDM for anti-TNFα drugs, describing evidence that supports the intervention and its cost effectiveness, steps that need to be adjusted in the care pathway, possible treatment algorithms and measures to assess adoption of this framework into clinical practice. For effective TDM, an assay for measurement of drug levels together with appropriate target ranges and an anti-drug-antibody assay have to be implemented. Also, instead of only reporting the drug concentration, laboratorians, pharmacists and clinicians should deliver added value by introducing a TDM-based treatment algorithm into clinical practice. Thus, to maximize effectiveness of TDM of anti-TNFα therapy in routine care, adjustment of current care pathways and cooperation of many stakeholders are needed. |
| Databáze: | OpenAIRE |
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