Symposium Therapeutic Drug Monitoring in inflammatory diseases
“In the past my waiting room was filled with wheelchairs”, rheumatoid arthritis professor Ronald van Vollenhoven from the AMC/VUmc reminded the audience. The room at public library in Amsterdam (OBA) was fully packed with physicians, clinical chemists, immunologists and global pharmaceutical teams. “That all changed when the biologics came on the marked, some ten years ago”.
Sanquin and AMC joined forces to put an attractive program together on Therapeutic Drug Monitoring (TDM) of biologics in December 2016. The symposium program covered inflammatory diseases such as rheumatology, dermatology, and gastroenterology with speakers and audience from Europe and the U.S. Biologics improved the quality of life for many patients with inflammatory diseases, but a more personalized approach is needed to reach an optimal effect and be cost effective at the same time.
TDM is considered to be crucial in precision medicine for biologics. Trough level measurements have increasingly become part of the daily practice for many clinicians prescribing biologics. When trough levels are lower than expected, anti-drug antibodies can be measured. Both tests can be informative to the clinician on how to proceed.
However, still little is known about drug levels between the moment of administration and the trough moment, a few weeks later. Pharmaco-dynamics differ widely between patients. Biologics are applied in several inflammatory specialisms, all with their own dosing schedule, albeit one-dose-fits-all. “Never before were so many diverse and relevant clinical and immunological cases presented in one setting”, said Annick the Vries, lab manager of Sanquin’s diagnostic department for Biologics.
The symposium was opened by Marcel Levi, former top executive of the AMC, now holding the same position at the University College London Hospitals. Levi encourages all to use expensive medications optimally and pleaded for more reasonable pricing.
The full and enticing program lead to great discussions. The first rapid tests and finger prick measurements may allow TDM at more frequent time points and might provide the next step towards personalized medicine. “The day flew by: we could have filled many more hours with discussions”, De Vries concluded. ‘’We most certainly will organise a follow-up symposium’’.
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