Therapeutic drug monitoring (TDM)

Requesting a blood level measurement of a drug is part of the global approach known as "Therapeutic Drug Monitoring". Diverse situations require this monitoring approach, such as inadequate response to treatment or organ failure. Every drug however does not possess all the characteristics for a TDM program. The therapeutic range of a TDM drug has indeed to be narrow and its interindividual pharmacokinetic variability to be wide.

As the development of new drugs is currently slowing down, the precise management of existing treatments certainly deserves progress, but needs however to be applied rationally, starting from a valid indication to blood sampling, and ending with a sound dosage adaptation decision.

TDM is an important research area of our Division of Clinical Pharmacology and Toxicology. We are indeed interested in the evaluation of the utilization and of the clinical benefit of blood concentration monitoring of drugs in patients, in order to optimize their pharmacological treatment. This research is carried out both on a practical (i.e. R&D projects, clinical trials) and theoretical (i.e. PK/PD and TDM meta-analyses) basis. We are mainly working on anti-HIV and targeted anticancer, but other drugs are also regularly evaluated (e.g. antivirals). This activity is performed in close link with the PK/PD modeling research activity of our Division.

Our Division is also in charge of providing clinical interpretations of routine drug levels performed in patients of the CHUV (and of Switzerland for some specific drugs). We are therefore performing practical research on the impact and the quality of this activity.
 

Our current R&D project is described on its dedicated page:

• Intelligent Integrated Systems for Personalized Medicine (ISyPeM)

Here are also some additional information about our main ongoing clinical trial:

• Imatinib Concentration Monitoring Evaluation (I-COME)