Proactive therapeutic drug monitoring (TDM) during infliximab induction does not improve disease remission rates in patients with spondyloarthritis, rheumatoid arthritis (RA) or other chronic immune-mediated inflammatory diseases, a trial shows.

TDM tailors biologic therapy to individual patients by measuring serum drug levels and antidrug antibodies (ADAs), and adjusting treatment doses based on the levels, with the goal of maximising the efficacy and safety of the biologic.

While proactive TDM has been adopted by some doctors, whether it improves clinical outcomes compared with standard therapy remains unclear, which was the reason for the trial, the investigators said.

The Norwegian Drug Monitoring (NOR-DRUM) trial included 398 patients with a mix of immune-modulated inflammatory diseases who were randomly allocated to proactive TDM or standard care while initiating infliximab.