FRI0192 Clinical Importance of Anti-Drug and Serum Drug Level Testing in Rheumatoid Arthritis Patients Treated with Etanercept

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 499.3-500
Author(s):  
S. Drynda ◽  
J. Kekow
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Importance ◽  
Drug Level ◽  
Serum Drug Level

scholarly journals Monitoring Drug and Antidrug Levels: A Rational Approach in Rheumatoid Arthritis Patients Treated with Biologic Agents Who Experience Inadequate Response While Being on a Stable Biologic Treatment

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Diana Mazilu ◽  
Daniela Opriş ◽  
Cecilia Gainaru ◽  
Mihaela Iliuta ◽  
Natalia Apetrei ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Response ◽  
Drug Level ◽  
Biologic Agents ◽  
Rational Approach ◽  
Inadequate Response ◽  
Das28 Score ◽  
Eular Response ◽  
Biologic Treatment ◽  
Serum Drug Level

Clinical response in patients with rheumatoid arthritis (RA) treated with biologic agents can be influenced by their pharmacokinetics and immunogenicity. The present study evaluated the concordance between serum drug and antidrug levels as well as the clinical response in RA patients treated with biological agents who experience their first disease exacerbation while being on a stable biologic treatment. 154 RA patients treated with rituximab (RTX), infliximab (IFX), adalimumab (ADL), or etanercept (ETN) were included. DAS28, SDAI, and EULAR response were assessed at baseline and reevaluated at precise time intervals. At the time of their first sign of inadequate response, patients were tested for both serum drug level and antidrug antibodies level. At the next reevaluation, patients retreated with RTX that had detectable drug level had a better EULAR response (P=0.038) with lower DAS28 and SDAI scores (P=0.01andP=0.03). The same tendency was observed in patients treated with IFX and ETN regarding EULAR response (P=0.002andP=0.023), DAS28 score (P=0.002andP=0.003), and SDAI score (P=0.001andP=0.026). Detectable biologic drug levels correlated with a better clinical response in patients experiencing their first RA inadequate response while being on a stable biologic treatment with RTX, IFX, and ETN.

scholarly journals Prescribing Habits for Theophylline Preparations

1983 ◽  
Vol 76 (11) ◽  
pp. 917-919 ◽  
Author(s):  
J K Wiffen ◽  
S H D Jackson
Keyword(s):  
Slow Release ◽  
Drug Level ◽  
Prescribing Habits ◽  
Serum Drug Level ◽  
Drug Level Monitoring ◽  
Level Monitoring

Information concerning the prescriptions for theophylline preparations for a group of 80 inpatients and 55 outpatients were examined. Slow-release preparations were overwhelmingly preferred. The majority of patients were receiving low daily doses of theophylline or equivalent, and serum drug level monitoring was almost non-existent.

Predicting serum drug level using the principles of pharmacokinetics after an overdose: a case of lithium overdose

2017 ◽  
Vol 25 (4) ◽  
pp. 391-394 ◽  
Author(s):  
Irosh Fernando
Keyword(s):  
Drug Overdose ◽  
Clinical Case ◽  
Drug Level ◽  
Optimum Time ◽  
Drug Levels ◽  
Lithium Overdose ◽  
Serum Drug Level

Objective: In cases of drug overdose, clinicians often find it challenging to predict serum drug level and decide the optimum time for recommencing the overdosed drug. Method: This paper describes how to predict serum drug level using the principles of pharmacokinetics. Results: The proposed method and recommencement of the overdosed drug is demonstrated using a clinical case of lithium overdose. Conclusion: The proposed method can assist clinicians in predicting serum drug levels and deciding the optimum time for recommencing the overdosed drug safely. Therefore, it may reduce unnecessary repeat serum drug level procedures.

scholarly journals Phenytoin intoxication with no symptoms correlated with serum drug level: a case study

2015 ◽  
Vol 22 ◽  
Author(s):  
Mucahit Avcil ◽  
Ali Duman ◽  
Kenan Ahmet Turkdogan ◽  
Mucahit Kapci ◽  
Ayhan Akoz ◽  
...  
Keyword(s):  
Drug Level ◽  
Serum Drug Level

Retrospective analysis of goal drug level attainment of posaconazole for invasive fungal infection prophylaxis in patients with acute myeloid leukemia pre- and post-switch to tablet formulation

2017 ◽  
Vol 24 (8) ◽  
pp. 599-603 ◽  
Author(s):  
Tyler K Liebenstein ◽  
Kristin M Widmer ◽  
Michael J Fallon
Keyword(s):  
Acute Myeloid Leukemia ◽  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Myeloid Leukemia ◽  
Oral Absorption ◽  
Drug Level ◽  
Tablet Formulation ◽  
Infection Prophylaxis ◽  
Serum Drug Level ◽  
Acute Myeloid

Background Posaconazole is approved for invasive fungal infection prophylaxis in patients with hematologic malignancies. Posaconazole suspension is plagued by poor oral absorption and dietary requirements that are difficult for patients to meet. The delayed-release tablet formulation of posaconazole may be taken without regards to meals and has significantly better oral absorption than posaconazole suspension. Objectives We sought to determine if a switch to posaconazole tablets improved steady-state drug level attainment for invasive fungal infection prophylaxis in patients with acute myeloid leukemia. Methods All adult inpatients with acute myeloid leukemia undergoing chemotherapy, who received posaconazole for invasive fungal infection prophylaxis between 2012 and 2015, were included. The primary outcome was proportion of patients with first posaconazole level greater than 700 ng/mL. Secondary outcomes included proportion of patients with first posaconazole level greater than 1000 ng/mL, invasive fungal infection within 100 days, and adverse drug events. Results Forty patients received posaconazole tablets and 34 patients received suspension. Posaconazole levels were significantly higher at first measurement in patients receiving tablet than suspension (1296 ng/mL vs. 788 ng/mL, p < 0.01). Thirty-seven patients receiving tablets had a serum drug level greater than 700 ng/mL on first measurement versus 18 receiving suspension (p < 0.01). Patients receiving tablets were also more likely to have a serum drug level over 1000 ng/mL on first measurement (26 vs. 11, p < 0.01). Rates of invasive fungal infection and adverse events were not statistically different. Conclusions Patients receiving posaconazole tablets attained significantly higher serum drug levels than those receiving suspension.

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