Therapeutic drug monitoring in inflammatory bowel disease : implementation, utilization, and barriers in clinical practice in Scandinavia
Background and aims Therapeutic drug monitoring (TDM) may optimize biologic and thiopurine therapies in inflammatory bowel disease (IBD). The study aimed to investigate implementation and utilization of TDM in Scandinavia. Methods A web-based questionnaire on the use of TDM was distributed to Scandi...
Published in: | Scandinavian Journal of Gastroenterology |
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Linköpings universitet, Avdelningen för diagnostik och specialistmedicin
2023
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Online Access: | http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-188142 https://doi.org/10.1080/00365521.2022.2108684 |
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ftlinkoepinguniv:oai:DiVA.org:liu-188142 2023-06-11T04:13:14+02:00 Therapeutic drug monitoring in inflammatory bowel disease : implementation, utilization, and barriers in clinical practice in Scandinavia Bjorlykke, Kristin H. Jahnsen, Jorgen Brynskov, Jorn Molander, Pauliina Eberhardson, Michael Davidsdottir, Loa G. Sipponen, Taina Hjortswang, Henrik Goll, Guro Lovik Syversen, Silje Watterdal Langholz, Ebbe Jorgensen, Kristin K. Steenholdt, Casper 2023 application/pdf http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-188142 https://doi.org/10.1080/00365521.2022.2108684 eng eng Linköpings universitet, Avdelningen för diagnostik och specialistmedicin Linköpings universitet, Medicinska fakulteten Region Östergötland, Mag- tarmmedicinska kliniken Akershus Univ Hosp, Norway; Univ Oslo, Norway Herlev Hosp, Denmark Helsinki Univ Hosp, Finland; Univ Helsinki, Finland Karolinska Inst, Sweden Univ Hosp Iceland, Iceland Diakonhjemmet Hosp, Norway Herlev Hosp, Denmark; Univ Copenhagen, Denmark Akershus Univ Hosp, Norway Taylor & Francis Ltd Scandinavian Journal of Gastroenterology, 0036-5521, 2023, 58:1, s. 25-33 http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-188142 doi:10.1080/00365521.2022.2108684 PMID 35996928 ISI:000843570300001 Scopus 2-s2.0-85136529247 info:eu-repo/semantics/openAccess Therapeutic drug monitoring clinical implementation biologics antibodies drug levels Gastroenterology and Hepatology Gastroenterologi Article in journal info:eu-repo/semantics/article text 2023 ftlinkoepinguniv https://doi.org/10.1080/00365521.2022.2108684 2023-04-26T22:30:52Z Background and aims Therapeutic drug monitoring (TDM) may optimize biologic and thiopurine therapies in inflammatory bowel disease (IBD). The study aimed to investigate implementation and utilization of TDM in Scandinavia. Methods A web-based questionnaire on the use of TDM was distributed to Scandinavian gastroenterologists via the national societies. Results In total, 297 IBD physicians prescribing biologic therapies, equally distributed between community and university hospitals, were included (response rate 42%) (Norway 118 (40%), Denmark 86 (29%), Sweden 50 (17%), Finland 33 (11%), Iceland 10 (3%)). Overall, TDM was applied during biologic therapies by 87%, and for TNF-inhibitors >90%. Among the users, reactive and proactive TDM were utilized by 90% and 63%, respectively. Danish physicians were significantly less inclined to use TDM compared to other Scandinavian countries; (58% vs 98%); OR 0.03 [0.01-0.09], p < 0.001). Reactive TDM was commonly applied at primary (74%) and secondary (99%) treatment failure. Proactive TDM was used by 80% during maintenance therapy and 56% during induction and more commonly utilized in Norway (p < 0.001), and by physicians managing >10 IBD patients/week (p = 0.005). TDM scenarios were interpreted in accord with available evidence but with discrepancies for proactive TDM. The main barriers to TDM were lack of guidelines (51%) and time lag between sampling and results (49%). TDM of thiopurines was routinely used by 87%. Conclusion TDM of biologic and thiopurine therapies has been broadly implemented into clinical practice in Scandinavia. However, physicians call for TDM guidelines detailing indications and interpretations of test results along with improved test response times. Funding Agencies|Akershus University Hospital Article in Journal/Newspaper Iceland LIU - Linköping University: Publications (DiVA) Norway Scandinavian Journal of Gastroenterology 58 1 25 33 |
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Open Polar |
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LIU - Linköping University: Publications (DiVA) |
op_collection_id |
ftlinkoepinguniv |
language |
English |
topic |
Therapeutic drug monitoring clinical implementation biologics antibodies drug levels Gastroenterology and Hepatology Gastroenterologi |
spellingShingle |
Therapeutic drug monitoring clinical implementation biologics antibodies drug levels Gastroenterology and Hepatology Gastroenterologi Bjorlykke, Kristin H. Jahnsen, Jorgen Brynskov, Jorn Molander, Pauliina Eberhardson, Michael Davidsdottir, Loa G. Sipponen, Taina Hjortswang, Henrik Goll, Guro Lovik Syversen, Silje Watterdal Langholz, Ebbe Jorgensen, Kristin K. Steenholdt, Casper Therapeutic drug monitoring in inflammatory bowel disease : implementation, utilization, and barriers in clinical practice in Scandinavia |
topic_facet |
Therapeutic drug monitoring clinical implementation biologics antibodies drug levels Gastroenterology and Hepatology Gastroenterologi |
description |
Background and aims Therapeutic drug monitoring (TDM) may optimize biologic and thiopurine therapies in inflammatory bowel disease (IBD). The study aimed to investigate implementation and utilization of TDM in Scandinavia. Methods A web-based questionnaire on the use of TDM was distributed to Scandinavian gastroenterologists via the national societies. Results In total, 297 IBD physicians prescribing biologic therapies, equally distributed between community and university hospitals, were included (response rate 42%) (Norway 118 (40%), Denmark 86 (29%), Sweden 50 (17%), Finland 33 (11%), Iceland 10 (3%)). Overall, TDM was applied during biologic therapies by 87%, and for TNF-inhibitors >90%. Among the users, reactive and proactive TDM were utilized by 90% and 63%, respectively. Danish physicians were significantly less inclined to use TDM compared to other Scandinavian countries; (58% vs 98%); OR 0.03 [0.01-0.09], p < 0.001). Reactive TDM was commonly applied at primary (74%) and secondary (99%) treatment failure. Proactive TDM was used by 80% during maintenance therapy and 56% during induction and more commonly utilized in Norway (p < 0.001), and by physicians managing >10 IBD patients/week (p = 0.005). TDM scenarios were interpreted in accord with available evidence but with discrepancies for proactive TDM. The main barriers to TDM were lack of guidelines (51%) and time lag between sampling and results (49%). TDM of thiopurines was routinely used by 87%. Conclusion TDM of biologic and thiopurine therapies has been broadly implemented into clinical practice in Scandinavia. However, physicians call for TDM guidelines detailing indications and interpretations of test results along with improved test response times. Funding Agencies|Akershus University Hospital |
format |
Article in Journal/Newspaper |
author |
Bjorlykke, Kristin H. Jahnsen, Jorgen Brynskov, Jorn Molander, Pauliina Eberhardson, Michael Davidsdottir, Loa G. Sipponen, Taina Hjortswang, Henrik Goll, Guro Lovik Syversen, Silje Watterdal Langholz, Ebbe Jorgensen, Kristin K. Steenholdt, Casper |
author_facet |
Bjorlykke, Kristin H. Jahnsen, Jorgen Brynskov, Jorn Molander, Pauliina Eberhardson, Michael Davidsdottir, Loa G. Sipponen, Taina Hjortswang, Henrik Goll, Guro Lovik Syversen, Silje Watterdal Langholz, Ebbe Jorgensen, Kristin K. Steenholdt, Casper |
author_sort |
Bjorlykke, Kristin H. |
title |
Therapeutic drug monitoring in inflammatory bowel disease : implementation, utilization, and barriers in clinical practice in Scandinavia |
title_short |
Therapeutic drug monitoring in inflammatory bowel disease : implementation, utilization, and barriers in clinical practice in Scandinavia |
title_full |
Therapeutic drug monitoring in inflammatory bowel disease : implementation, utilization, and barriers in clinical practice in Scandinavia |
title_fullStr |
Therapeutic drug monitoring in inflammatory bowel disease : implementation, utilization, and barriers in clinical practice in Scandinavia |
title_full_unstemmed |
Therapeutic drug monitoring in inflammatory bowel disease : implementation, utilization, and barriers in clinical practice in Scandinavia |
title_sort |
therapeutic drug monitoring in inflammatory bowel disease : implementation, utilization, and barriers in clinical practice in scandinavia |
publisher |
Linköpings universitet, Avdelningen för diagnostik och specialistmedicin |
publishDate |
2023 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-188142 https://doi.org/10.1080/00365521.2022.2108684 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
Scandinavian Journal of Gastroenterology, 0036-5521, 2023, 58:1, s. 25-33 http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-188142 doi:10.1080/00365521.2022.2108684 PMID 35996928 ISI:000843570300001 Scopus 2-s2.0-85136529247 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.1080/00365521.2022.2108684 |
container_title |
Scandinavian Journal of Gastroenterology |
container_volume |
58 |
container_issue |
1 |
container_start_page |
25 |
op_container_end_page |
33 |
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1768389994102128640 |