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Comment & Response
September 21, 2021

Therapeutic Drug Monitoring vs Standard Therapy During Infliximab Induction in Patients With Chronic Immune-Mediated Inflammatory Diseases—Reply

Author Affiliations
  • 1Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
  • 2Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
JAMA. 2021;326(11):1069-1070. doi:10.1001/jama.2021.11480

In Reply In response to our study1 on TDM during infliximab induction, 3 letters address different aspects of the study design. Dr Papamichail and colleagues propose that subpopulations of patients with IBD may benefit from higher drug levels than recommended by the study algorithm. Our therapeutic range was based on data available when the study was being planned and after consultation with key opinion leaders on the international advisory board. The therapeutic range in NOR-DRUM Part A is consistent with prior studies and treatment guidelines.2-4 We cannot exclude additional benefit from higher infliximab levels on endoscopic remission in IBD subpopulations as suggested by Papamichail and colleagues based on cross-sectional postinduction data, but we await data from prospective studies.