Pediatric inflammatory bowel disease (IBD) is a debilitating chronic condition that affects the gastrointestinal tract of children. The symptoms are similar to adults with IBD, but due to the developing immune system, pediatric patients have different needs than adults when it comes to treatment. As such, there has been an increasing need for therapeutic drug monitoring (TDM) in pediatric IBD patients.
What is Therapeutic Drug Monitoring?
According to NCBI, “therapeutic drug monitoring is the clinical practice of measuring specific drugs at designated intervals to maintain appropriate concentrations in a patient’s bloodstream, thereby optimizing individual dosage regimens.”
Therapeutic drug monitoring can be an excellent tool for improving the efficacy and safety of a medication. It allows clinicians to monitor how quickly patients start feeling better after taking their medications, as well as whether there are any negative side effects from these drugs in order to make adjustments as needed. According to an article published on Frontiers in Pediatrics, “model-based dosing for biologics offers an exciting insight into dose individualization, thereby minimizing the chances of losing response.”
Therapeutic Drug Monitoring for Pediatric Inflammatory Bowel Disease
For children who suffer from IBD, therapeutic drug monitoring algorithms are being developed and are specifically designed to target pediatric needs. The goal here is not only stopping symptoms but also recovering more quickly between flare-ups through tailoring therapies towards specific age groups and characteristics.
Biologic agents were initially utilized as second-line therapy in case treatment failed with conventional medication. However, biologics are now considered as a primary induction option for children with active perianal fistulizing disease.
Currently, most of the biologic agents, including Infliximab (IFX), a monoclonal antibody for IBD, are administered on the basis of fixed dosing or weight-based dosing algorithms. In most cases, the administration of this drug is based on a “one-size-fits-all” approach.
According to this article, “subsequent studies performed by Dr. Marla Dubinsky et al. have employed precision dosing models (Bayesian population-based pharmacokinetic model with weight, albumin, CRP, previous drug, and antibody levels added) to aim at prespecified individual TLs.” By using these Bayesian models, routine lab results and demographic information, clinicians are able to individualize dosing to a specific target trough level.
The development of adaptive dosing dashboards utilizing Bayesian models is the future of personalized medicine in IBD. The article suggests that “when combining point-of-care TDM and biomarker testing, this has the potential to revolutionize how pediatric IBD will be treated in the coming years.”
Dosing Made Easier
Baysient’s software, iDose, is an integrative, cloud-based software that facilitates individualized dosing of all marketed MAbs used to treat a wide range of inflammatory diseases. iDose uses Bayesian models, routine lab results and demographic information to allow physicians to individualize dosing to a specific target trough level.
iDose is revolutionizing the way inflammatory-disease patients are treated, improving the effectiveness of Infliximab, and ensuring patients do not develop drug-resistant antibodies too soon into treatment, thus reducing adverse events and preserving durability of efficacy with these agents. By providing individualized dosing regimens, iDose reduces the chance of drug failure, helping patients reach and maintain remission while lowering overall healthcare costs.
To learn more about how iDose can improve your patient outcomes, schedule your demo online today.