Proactive therapeutic drug monitoring of anti-TNF therapy offers no clinical benefit in patients with inflammatory bowel disease, regardless of disease activity, a meta-analysis shows.

Although routine monitoring of serum biologic levels has been proposed to improve outcomes in this clinical setting, US-led researchers say it is no better than conventional management.

However, they add that therapeutic drug monitoring (TDM) in paediatric patients “merits further consideration” as standard anti-TNF dosing regimens may not be applicable in younger age groups.

The team, led by the University of California, San Diego, reviewed data from nine clinical trials comparing proactive routine TDM with conventional management in 1405 patients treated with TNF-alpha (TNF-a) antagonists for inflammatory bowel disease (IBD).