Therapeutic Drug Monitoring in TB

Today we speak to Professor Jan-Willem Alffenaar from Westmead Hospital and the University of Sydney about Therapeutic Drug Monitoring in Tuberculosis. Professor Alffenaar reviews the PK/PD issues with common TB medications, the strengths and weaknesses of TDM and how best to utilise TDM in the treatment of TB patients. REFERENCES1) personalised dosing of TB drugsClinical standards for the dosing and management of TB drugsAlffenaar JW, Stocker SL, Forsman LD, Garcia-Prats A, Heysell SK, Aarnoutse RE, Akkerman OW, Aleksa A, van Altena R, de Onata WA, Bhavani PK. Clinical standards for the dosing and management of TB drugs. The International Journal of Tuberculosis and Lung Disease. 2022 Jun 1;26(6):483-99.Population Pharmacokinetics and Bayesian Dose Adjustment to Advance TDM of Anti-TB Drugs.Sturkenboom MG, Märtson AG, Svensson EM, Sloan DJ, Dooley KE, van den Elsen SH, Denti P, Peloquin CA, Aarnoutse RE, Alffenaar JW. Population pharmacokinetics and Bayesian dose adjustment to advance TDM of anti-TB drugs. Clinical pharmacokinetics. 2021 Jun;60:685-710.2) drug exposure - pathogen susceptibility - treatment outcomeDrug exposure and susceptibility of second-line drugs correlate with treatment response in patients with multidrug-resistant tuberculosis: a multicentre prospective cohort study in China.Zheng X, Forsman LD, Bao Z, Xie Y, Ning Z, Schön T, Bruchfeld J, Xu B, Alffenaar JW, Hu Y. Drug exposure and susceptibility of second-line drugs correlate with treatment response in patients with multidrug-resistant tuberculosis: a multicentre prospective cohort study in China. European Respiratory Journal. 2022 Mar 1;59(3).Drug Exposure and Minimum Inhibitory Concentration Predict Pulmonary Tuberculosis Treatment Response.Zheng X, Bao Z, Forsman LD, Hu Y, Ren W, Gao Y, Li X, Hoffner S, Bruchfeld J, Alffenaar JW. Drug exposure and minimum inhibitory concentration predict pulmonary tuberculosis treatment response. Clinical Infectious Diseases. 2021 Nov 1;73(9):e3520-8.3) TDM frameworkTherapeutic Drug Monitoring of Anti-infective Drugs: Implementation Strategies for 3 Different Scenarios.Kim HY, Byashalira KC, Heysell SK, Märtson AG, Mpagama SG, Rao P, Sturkenboom MG, Alffenaar JW. Therapeutic drug monitoring of anti-infective drugs: implementation strategies for 3 different scenarios. Therapeutic Drug Monitoring. 2022 Feb 1;44(1):3-10.4) point of care TDMA mobile microvolume UV/visible light spectrophotometer for the measurement of levofloxacin in saliva.Alffenaar JW, Jongedijk EM, van Winkel CA, Sariko M, Heysell SK, Mpagama S, Touw DJ. A mobile microvolume UV/visible light spectrophotometer for the measurement of levofloxacin in saliva. Journal of Antimicrobial Chemotherapy. 2021 Feb;76(2):423-9.Levofloxacin pharmacokinetics in saliva as measured by a mobile microvolume UV spectrophotometer among people treated for rifampicin-resistant TB in Tanzania.Mohamed S, Mvungi HC, Sariko M, Rao P, Mbelele P, Jongedijk EM, van Winkel CA, Touw DJ, Stroup S, Alffenaar JW, Mpagama S. Levofloxacin pharmacokinetics in saliva as measured by a mobile microvolume UV spectrophotometer among people treated for rifampicin-resistant TB in Tanzania. Journal of Antimicrobial Chemotherapy. 2021 Jun;76(6):1547-52.