Precision and personalized medicine and anti-TB treatment: Is TDM feasible for programmatic use?

Jan Willem C. Alffenaar, Onno W. Akkerman, Hannah Yejin Kim, Simon Tiberi, Giovanni Battista Migliori

Research output: Contribution to journalArticlepeer-review

Abstract

Therapeutic Drug Monitoring (TDM) is increasingly recommended to ensure the correct drug dose thereby minimizing adverse events and maximizing regimen efficacy. To facilitate implementation in TB programs, a framework for TDM is urgently needed. TDM is only useful for dose optimization if a patient is on an appropriate regimen guided by drug susceptibility testing. TDM using a targeted approach selecting patients with risk factors for suboptimal drug exposure (e.g. diabetes) or not responding to treatment for drugs with a clear concentration-response relationship may provide the best value for money. Semiquantitative point-of-care tests for detection of low or high drug concentration should be implemented at community level while quantitative assays can be performed at regional or central level. Expanding PK/PD research followed by clinical trials including both clinical outcome as well as cost-effectiveness will increase the level of evidence supporting TDM.

Original languageEnglish
Pages (from-to)S5-S9
JournalInternational Journal of Infectious Diseases
Volume92
DOIs
Publication statusPublished - Mar 2020

Keywords

  • AR-JP
  • Autophagy
  • Mitophagy
  • Parkin
  • Parkinson's disease
  • PINK1
  • Proteasome
  • Ubiquitin

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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