Leading Edge 2021 Issue 2

10 LEADING EDGE - 2021-2 IBD Therapeutic Drug Monitoring - Be in Control of Your TAT Adopt a Proactive Approach to Therapeutic Drug Monitoring for IBD Patients A recent UK national survey by Nigam et al., published in Frontline Gastroenterology 2021, investigated gastros’ attitudes towards therapeutic drug monitoring (TDM) of anti-TNF therapy in their inflammatory bowel disease patients. 85% of respondents said they would proactively monitor on an annual basis if the barriers were removed. The primary barrier cited was the time lag in receiving results. Rapid Testing Using the BÜHLMANN Quantum Blue system, results can be available within an hour. This enables real-time dose adjustment for infliximab and adalimumab, facilitating optimisation of treatment, minimising loss of response and side effects and saving valuable healthcare resources. Proactive Monitoring Proactive anti-TNF drug and anti-drug antibody monitoring can improve clinical outcomes through the maintenance of levels within therapeutic windows. This prevents sub-therapeutic levels which may enable low level inflammation that can cause tissue damage or trigger a flare. It also means supra-therapeutic levels can be de-escalated, minimising side effects and saving costs. Clarissa Rentsch at Alfred Health, Melbourne, Australia “This rapid test strategy has the potential to reduce patient risks and improve patient outcomes without negative cost implications” Watch the Presentation from ECCO https://youtu.be/TizubO07C1M Maria Pia Costa Santos from Hospital Beatriz Angelo, Loures, Portugal “Point of care infliximab trough levels were easy to implement into a daily practice setting. The therapeutic window was achieved in only a third of patients, in the remaining patients an immediate treatment adjustment was possible enabling a cost saving” Watch the Presentation from ECCO https://youtu.be/QNPMkaq-LD8 Quantum Blue® Reader ■ Quantitative results: - Infliximab 0.4 - 20µg/ml (linear up to 180µg/ml) - Adalimumab 1.3 - 35µg/ml ■ Anti-drug antibody assays available ■ Excellent correlation with the WHO infliximab standard ■ Simple bench top reader - Touch screen data entry - LIMs enabled for easy data entry and reporting ■ Ideal for use in POC: - No need to batch samples - Individually packaged single use tests to maintain quality until use - Small pack sizes available Reference Nigam GB, Nayeemuddin S, Kontopantelis E, et al. UK National Survey of Gastroenterologists’ attitudes and barriers toward therapeutic drug monitoring of anti-TNF therapy in inflammatory bowel disease. Frontline Gastroenterology 2021;12:22-29. For more information on Quantum Blue for TDM or to arrange a demonstration, please visit: www.calprotectin.co.uk/TDM