Precision and Personalized Medicine and anti-TB treatment: Is TDM feasible for programmatic use?

Alffenaar, J-W. C., Akkerman, O. W., Kim, H. Y., Tiberi, S. & Battista Migliori, G., 1-Mar-2020, In : International Journal of Infectious Diseases. 92, p. S5-S9 5 p.

Research output: Contribution to journalArticleAcademicpeer-review

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 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
Number of pages5
JournalInternational Journal of Infectious Diseases
Early online date26-Jan-2020
Publication statusPublished - 1-Mar-2020

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