抗肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)制剂,如英夫利西单抗(infliximab,IFX),是我国目前具有儿童炎症性肠病(inflammatory bowel disease,IBD)应用适应证的生物制剂.随着IFX的临床应用,IBD的治疗目标从临床缓解转向黏膜愈合,从而进一步改善疾病的转归.但临床工作中发现部分患儿对IFX治疗原发性无应答或继发性失应答,这是IFX治疗过程中的一大难题,研究发现这一现象可能与血药浓度降低及抗药抗体的产生相关.因此,IFX的治疗药物监测(therapeutic drug monitoring,TDM)在儿童IBD治疗中非常重要.该文综述了 IFX治疗儿童IBD过程中TDM的应用现状,并对TDM未来的研究方向提出展望.
Advances in therapeutic drug monitoring of infliximab in pediatric inflammatory bowel disease
Infliximab(IFX)is one of anti-tumor necrosis factor-α(anti-TNF-α)and is currently biological preparations with indications for the use of inflammatory bowel disease(IBD)of children in China.With the clinical application of IFX,the treatment goal of IBD has shifted from clinical remission to mucosal healing,thereby further improving the prognosis of the disease.However,in clinical work,it has been found that some children have primary or secondary unresponsiveness to IFX treatment,which is a major challenge during the IFX treatment process.Research has found that this phenomenon may be related to a decrease in blood drug concentration and the production of anti drug antibodies.Therefore,IFX therapeutic drug monitoring(TDM)is very important in the treatment of pediatric IBD.This article reviews the current application status of TDM in the treatment of IBD in children with IFX,and puts forward prospects for future research directions of TDM.
ChildInfliximabInflammatory bowel diseaseTherapeutic drug monitoringBlood drug concentration