As a plethora of data emerges on therapeutic drug monitoring (TDM) of biologics in inflammatory bowel disease, guidance on its application is needed. In this literature review and consensus statement, the authors recommend reactive TDM for all biologics, summarize concentration targets, and provide guidance on TDM in various scenarios. Proactive TDM with tumor necrosis factor-antagonist monotherapy is recommended as an alternative to the combination of tumor necrosis factor-antagonists with immunomodulators. Although observational data support this approach, randomized controlled trials do not. We argue that there is considerable work left to be performed before embracing proactive TDM as an equivalent alternative to combination therapy in inflammatory bowel disease.

中文翻译：

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主动治疗药物监测是否准备好成为炎症性肠病的焦点？关注数据。

随着炎症性肠病生物制剂治疗药物监测 (TDM) 的大量数据出现，需要对其应用提供指导。在这篇文献综述和共识声明中，作者推荐了所有生物制剂的反应性 TDM，总结了浓度目标，并为各种情况下的 TDM 提供了指导。推荐使用肿瘤坏死因子拮抗剂单一疗法的主动 TDM 作为肿瘤坏死因子拮抗剂与免疫调节剂组合的替代方案。尽管观察数据支持这种方法，但随机对照试验不支持。我们认为，在采用主动 TDM 作为炎症性肠病联合治疗的等效替代方案之前，还有大量工作要做。