World's First Identification of "Therapeutic Drug Monitoring-Based Proactive Treatment" for Pediatric Crohn's Disease

Photo by Kangbuk Samsung Hospital

Recently, a team of Korean medical professionals became the first in the world to identify the results of a study on a "therapeutic drug monitoring-based proactive treatment strategy" using infliximab for pediatric Crohn's disease.

According to Kangbuk Samsung Hospital on June 25, Professor Kim Eunsil of the Department of Pediatrics at Kangbuk Samsung Hospital, Professor Kang Bin of Kyungpook National University, and Professor Choi Yeonho of Samsung Medical Center published their findings in the renowned gastroenterology journal Clinical Gastroenterology and Hepatology. Their study demonstrated that a "therapeutic drug monitoring-based proactive treatment approach" is more effective than conventional clinical treatment methods.

Infliximab is a representative biologic agent used in the treatment of Crohn's disease. In conventional clinical treatment for Crohn's disease, maintenance therapy is administered every eight weeks following initial induction therapy. If a patient's symptoms worsen, the maintenance therapy interval is shortened to every six or four weeks. However, because maintenance therapy is a strategy implemented after the patient's Crohn's disease symptoms have already worsened, the need for a proactive treatment approach has emerged.

To address this, the research team randomly assigned 112 Korean pediatric Crohn's disease patients, diagnosed between 2017 and 2020, into two groups: a conventional clinical treatment group and a therapeutic drug monitoring-based proactive treatment group. In the therapeutic drug monitoring group, infliximab was administered proactively by monitoring drug levels through blood tests, regardless of symptom exacerbation, to maintain a minimum serum infliximab concentration of at least 6 ug/mL.

After one year, the team compared the endoscopic remission rate and clinical remission maintenance rate between the conventional clinical treatment group and the therapeutic drug monitoring-based proactive treatment group.

The results showed that the endoscopic remission rate was 57.1% in the conventional clinical treatment group and 80% in the therapeutic drug monitoring-based treatment group. The clinical remission maintenance rates were 69.6% and 89.3%, respectively.

Professor Kim Eunsil of Kangbuk Samsung Hospital’s Department of Pediatrics stated, "The treatment strategy based on therapeutic drug monitoring was effective in both endoscopic remission rate and clinical remission maintenance rate. This suggests that personalized treatment based on therapeutic drug monitoring can enhance the precision and maximize the effectiveness of treatment for pediatric Crohn's disease patients."

She added, "This study is significant as a new personalized treatment option for pediatric Crohn's disease patients. We will continue to do our best to improve the quality of life for Crohn's disease patients in the future."

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