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Letter
Importance of defining loss of response before therapeutic drug monitoring
  1. Malcolm Tan
  1. Correspondence to Dr Malcolm Tan, Department of Gastroenterology and Hepatology, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore; dr.malcolm{at}gmail.com

https://doi.org/10.1136/gutjnl-2014-307877

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    Dear Sir,

    I read with interest the study by Steenholdt et al 1 which concluded that individualised infliximab therapy was more cost effective compared with empirical dose escalation in Crohn's disease (CD) patients who developed secondary non-response to infliximab.

    The study methodology has a number of questions that require attention.

    First, 80% of the patients recruited for the study had non-fistulising disease, and the study entry criterion for them was having a Crohn's Disease Activity Index (CDAI) score of ≥220. Furthermore, the endpoint for clinical response …

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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