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

被引：22

作者：

Alffenaar, Jan-Willem C. ^{[1
,2
,3
]}

Akkerman, Onno W. ^{[4
,5
]}

Kim, Hannah Yejin ^{[1
,2
]}

Tiberi, Simon ^{[6
,7
]}

Migliori, Giovanni Battista ^{[6
,8
]}

机构：

[1] Univ Sydney, Fac Med & Hlth, Sydney Pharm Sch, Camperdown, NSW 2006, Australia

[2] Westmead Hosp, Westmead, NSW 2145, Australia

[3] Univ Sydney, Marie Bashir Inst Infect Dis & Biosecur, Camperdown, NSW 2006, Australia

[4] Univ Groningen, Univ Med Ctr Groningen, Dept Pulm Dis & TB, Groningen, Netherlands

[5] Univ Groningen, Univ Med Ctr Groningen, TB Ctr Beatrixoord, Haren, Netherlands

[6] Queen Mary Univ London, Barts & London Sch Med & Dent, Blizard Inst, London, England

[7] Barts Hlth NHS Trust, Dept Infect, Royal London & Newham Hosp, London, England

[8] Ist Clin Sci Maugeri IRCCS, Serv Epidemiol Clin Malattie Resp, Tradate, Italy

来源：

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES | 2020年 / 92卷

关键词：

AR-JP; PINK1; Parkin; Parkinson's disease; Mitophagy; Ubiquitin; Proteasome; Autophagy; MULTIDRUG-RESISTANT TUBERCULOSIS; DRUG-RESISTANT; MUTATIONS; GYRA;

D O I：

10.1016/j.ijid.2020.01.041

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

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. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

引用

页码：S5 / S9

页数：5

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