Innovative strategies to optimise treatment for chronic inflammatory diseases

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The right drug at the right dose for the right patient

Chronic inflammatory diseases affect 5% to 7% of the population, regardless of age or sex, from children to the elderly. Chronic inflammatory diseases encompass a range of conditions. The most common inflammatory diseases include rheumatoid arthritis, Crohn’s disease, psoriasis, and multiple sclerosis among others.

Few of the current therapies for chronic inflammatory diseases are effective and even though some may control the disease, they do not provide a cure. To overcome these problems, researchers and clinicians are focusing on several topics to improve patient care in treatment with therapeutic antibodies.

The landscape of treating chronic inflammatory diseases has seen a significant transformation with the advent of targeted therapies employing therapeutic antibodies. However, a notable segment of patients either do not respond adequately to the treatment or experience a decline in responsiveness over time. This challenge is primarily linked to issues such as suboptimal dosing, immunogenicity, and variations in pharmacokinetics, (how the drugs circulate through the body) among different patients.

In response to this critical need for more effective treatment, researchers have initiated a strategic shift towards personalised treatment approaches. This involves the development of patient stratification tools and leveraging therapeutic drug monitoring (TDM) to tailor dosages based on serum drug concentrations.

The potential for a substantial enhancement in patient care is immense by implementing individualised (TDM-guided) dosing schemes of therapeutic antibodies in routine clinical practice for treating chronic inflammatory diseases. This tailored approach will ultimately lead to more efficient utilisation of these valuable but costly drugs, ensuring the right drug at the right dose for the right patient”.

However, Europe faces a challenge in the fragmentation of expertise related to individualised (TDM-guided) treatment optimisation. The knowledge and techniques required for effective implementation are concentrated in a limited number of pioneering centers, making dissemination to other centers challenging. Notably, the lack of standardisation in TDM assays adds to the complexity.

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