scholarly journals The Importance of Analytical Chemistry in Therapeutic Drug Monitoring for Personalized Medicine

2020 ◽  
Keyword(s):  
Analytical Chemistry ◽  
Therapeutic Drug Monitoring ◽  
Personalized Medicine ◽  
Drug Monitoring ◽  
Therapeutic Drug

scholarly journals Personalized Medicine of Monoclonal Antibodies in Inflammatory Bowel Disease: Pharmacogenetics, Therapeutic Drug Monitoring, and Beyond

2021 ◽  
Vol 11 ◽  
Author(s):  
Antonello Di Paolo ◽  
Giacomo Luci
Keyword(s):  
Monoclonal Antibodies ◽  
Therapeutic Drug Monitoring ◽  
Personalized Medicine ◽  
Drug Monitoring ◽  
Plasma Concentrations ◽  
Individual Characteristics ◽  
Therapeutic Drug ◽  
Therapeutic Effects ◽  
Primary Resistance ◽  
Inflammatory Bowel

The pharmacotherapy of inflammatory bowel diseases (Crohn’s disease and ulcerative colitis) has experienced significant progress with the advent of monoclonal antibodies (mABs). As therapeutic proteins, mABs display peculiar pharmacokinetic characteristics that differentiate them from chemical drugs, such as aminosalicylates, antimetabolites (i.e., azathioprine, 6-mercaptopurine, and methotrexate), and immunosuppressants (corticosteroids and cyclosporine). However, clinical trials have demonstrated that biologic agents may suffer from a pharmacokinetic variability that could influence the desired clinical outcome, beyond primary resistance phenomena. Therefore, therapeutic drug monitoring (TDM) protocols have been elaborated and applied to adaptation drug doses according to the desired plasma concentrations of mABs. This activity is aimed at maximizing the beneficial effects of mABs while sparing patients from toxicities. However, some aspects of TDM are still under discussion, including time-changing therapeutic ranges, proactive and reactive approaches, the performance and availability of instrumental platforms, the widely varying individual characteristics of patients, the severity of the disease, and the coadministration of immunomodulatory drugs. Facing these issues, personalized medicine in IBD may benefit from a combined approach, made by TDM protocols and pharmacogenetic analyses in a timeline that necessarily considers the frailty of patients, the chronic administration of drugs, and the possible worsening of the disease. Therefore, the present review presents and discusses the activities of TDM protocols using mABs in light of the most recent results, with special attention on the integration of other actions aimed at exploiting the most effective and safe therapeutic effects of drugs prescribed in IBD patients.

scholarly journals Personalized Medicine for Antibiotics: The Role of Nanobiosensors in Therapeutic Drug Monitoring

2020 ◽  
Vol 10 (4) ◽  
pp. 147
Author(s):  
Vivian Garzón ◽  
Rosa-Helena Bustos ◽  
Daniel G. Pinacho
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Personalized Medicine ◽  
Drug Monitoring ◽  
Bacterial Resistance ◽  
Low Cost ◽  
Fundamental Aspect ◽  
Therapeutic Drug ◽  
Toxic Dose ◽  
Biological Recognition ◽  
Sensitivity Specificity

Due to the high bacterial resistance to antibiotics (AB), it has become necessary to adjust the dose aimed at personalized medicine by means of therapeutic drug monitoring (TDM). TDM is a fundamental tool for measuring the concentration of drugs that have a limited or highly toxic dose in different body fluids, such as blood, plasma, serum, and urine, among others. Using different techniques that allow for the pharmacokinetic (PK) and pharmacodynamic (PD) analysis of the drug, TDM can reduce the risks inherent in treatment. Among these techniques, nanotechnology focused on biosensors, which are relevant due to their versatility, sensitivity, specificity, and low cost. They provide results in real time, using an element for biological recognition coupled to a signal transducer. This review describes recent advances in the quantification of AB using biosensors with a focus on TDM as a fundamental aspect of personalized medicine.

Therapeutic Drug Monitoring in Pediatric IBD: Current Application and Future Perspectives

2018 ◽  
Vol 25 (24) ◽  
pp. 2840-2854 ◽  
Author(s):  
S. Lega ◽  
M. Bramuzzo ◽  
M.C. Dubinsky
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Personalized Medicine ◽  
Drug Monitoring ◽  
Drug Exposure ◽  
Current Knowledge ◽  
Symptom Control ◽  
Therapeutic Drug ◽  
Current Application ◽  
Pediatric Ibd

Background: as the paradigm for IBD management is evolving from symptom control to the more ambitious goal of complete deep remission, the concept of personalized medicine, as a mean to deliver individualized treatment with the best effectiveness and safety profile, is becoming paramount. Therapeutic drug monitoring (TDM) is an essential part of personalized medicine and its role in the management of IBD patients is rapidly expanding. <p> Objective: to review the current knowledge that poses the rationale for the use of TDM, and the present and future role of TDM-based approaches in the management of pediatric IBD. <p> Method: literature review. <p> Results: the concept of TDM has been introduced in the field of IBD along with thiopurines, over a decade ago, and evolved around anti-TNF therapies. TDM-based strategies proved to be costeffective in the management of patients with loss of response to biologics and, more recently, proactive TDM to optimize drug exposure has been shown to reduce treatment failure and drug adverse events. The role of TDM with new biologics and the usefulness of software-systems support tools to guide drug dosing are now under investigation. <p> Conclusion: Therapeutic drug monitoring has the potential to maximize the cost-benefit profile of therapies and is becoming an essential part of IBD management.

scholarly journals A high-specificity immunoassay for the therapeutic drug monitoring of cyclophosphamide

The Analyst ◽  
2019 ◽  
Vol 144 (17) ◽  
pp. 5172-5178 ◽  
Author(s):  
Marta Broto ◽  
Rita McCabe ◽  
Roger Galve ◽  
M.-Pilar Marco
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Personalized Medicine ◽  
Drug Monitoring ◽  
High Specificity ◽  
Diagnostic Techniques ◽  
Toxic Effects ◽  
Therapeutic Drug

Personalized medicine is pushing forward new diagnostic techniques to aid in controlling drug therapeutic levels and their toxic effects.

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