Could therapeutic drug monitoring of anti-TNF-α be useful to consider a de-escalation of treatment?

Abstract

In recent years, many retrospective studies have demonstrated the interest of therapeutic anti-TNF drug monitoring in inflammatory bowel disease. This could be especially helpful in two different situations: a secondary loss of anti-TNF response where a re-elevation of drug levels by treatment optimization is predictive of better clinical outcome; a therapeutic de-escalation or discontinuation for Crohn's disease patients in long-standing remission where an undetectable anti-TNF drug level could be predictive of clinical remission.