基于治疗药物监测优化阿达木单抗治疗:当前证据和展望

Optimizing adalimumab therapies using therapeutic drug monitoring:current evidence and future perspectives

治疗药物监测(TDM)已在免疫抑制剂、抗癫痫药物和抗生素等小分子药物中应用较为广泛,但目前在生物药物领域中关注较少。以肿瘤坏死因子α(TNF-α)抑制剂为代表的单抗药物在临床研究中观察到了良好的暴露剂量与疗效的关系,基于研究证据已有相应的指南和共识进行了相应的TDM推荐。因此本文从阿达木单抗的TDM临床实践角度,介绍当前TDM在阿达木单抗优化治疗中的证据、策略和考虑要点,以期为阿达木单抗TDM临床应用提供参考。

Therapeutic drug monitoring(TDM)has been more widely used in small molecule agents,such as immuno-suppressants,antiepileptic drugs and antibiotics,with less attention in the field of therapeutic biological agents.Monoclonal drugs represented by tumor necrosis factor alpha(TNF-α)inhibitors have shown a good relationship between exposure and efficacy in clinical studies.There are corresponding guidelines and consensus for the recommendations of TDM based on current research evidence.Therefore,this paper introduced the current evidence,strategies and considerations for TDM in the optimal treatment of adalimumab from the perspective of adalimumab TDM to provide references for the clinical practice of adalimumab TDM.