Position paper on therapeutic drug monitoring of antiretroviral agents

Edward P. Acosta, Courtney V. Fletcher, Charles Flexner, David Haas, Stephen Hall, Fayez Hamzeh, Richard Haubrich, Angela Kashuba, David Katzenstein, Jody Lawrence, Juan Lertora, John G. Gerber, Michael Para, Susan Rosenkranz, Lewis Sheiner, Grant Wilkinson, Alastair J J Wood, Hulin Wu, Gene Morse, Judith AbergFrancesca Aweeka, Melissa Berry, Terrence Blaschke, Richard Brundage, Rolf Christensen

Research output: Contribution to journalArticle

Abstract

Monitoring drug concentrations in humans to optimize efficacy and reduce toxicity is not a new concept in clinical pharmacology. It has been successfully applied to many different classes of drugs. As a result of considerable concentration and response data, the concept of therapeutic drug monitoring (TDM) has been expanded to certain antiretroviral compounds. In particular, protease inhibitors and nonnucleoside reverse transcriptase inhibitors may be viable candidates for TDM, and limited clinical trial data suggest monitoring plasma concentrations of these agents may indeed clinically benefit patients with HIV infection. A primary distinction between TDM of antiretroviral drugs compared with other drugs is that multiple agents are concomitantly used to treat HIV infection. As with all illnesses that require self-administered drug therapy, poor adherence is a major impediment to success. However, in the treatment of HIV infection, inadequate drug concentrations will result in the appearance or evolution of drug resistance mutations that can endanger present and future drug treatment options. Procedures for sample collection, cross-validation of analytical procedures, and interpretation of assay results should be standardized. More clinical data are needed to confirm this approach and methods of implementing TDM should be further explored. This position paper offers guidelines to aid clinicians who choose to incorporate TDM into the routine care of their patients.

Original languageEnglish (US)
Pages (from-to)825-834
Number of pages10
JournalAIDS Research and Human Retroviruses
Volume18
Issue number12
DOIs
StatePublished - 2002
Externally publishedYes

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Anti-Retroviral Agents
Drug Monitoring
HIV Infections
Pharmaceutical Preparations
Reverse Transcriptase Inhibitors
Clinical Pharmacology
Protease Inhibitors
Drug Resistance
Patient Care
Clinical Trials
Guidelines
Drug Therapy
Mutation
Therapeutics

ASJC Scopus subject areas

  • Immunology
  • Virology

Cite this

Acosta, E. P., Fletcher, C. V., Flexner, C., Haas, D., Hall, S., Hamzeh, F., ... Christensen, R. (2002). Position paper on therapeutic drug monitoring of antiretroviral agents. AIDS Research and Human Retroviruses, 18(12), 825-834. https://doi.org/10.1089/08892220260190290

Position paper on therapeutic drug monitoring of antiretroviral agents. / Acosta, Edward P.; Fletcher, Courtney V.; Flexner, Charles; Haas, David; Hall, Stephen; Hamzeh, Fayez; Haubrich, Richard; Kashuba, Angela; Katzenstein, David; Lawrence, Jody; Lertora, Juan; Gerber, John G.; Para, Michael; Rosenkranz, Susan; Sheiner, Lewis; Wilkinson, Grant; Wood, Alastair J J; Wu, Hulin; Morse, Gene; Aberg, Judith; Aweeka, Francesca; Berry, Melissa; Blaschke, Terrence; Brundage, Richard; Christensen, Rolf.

In: AIDS Research and Human Retroviruses, Vol. 18, No. 12, 2002, p. 825-834.

Research output: Contribution to journalArticle

Acosta, EP, Fletcher, CV, Flexner, C, Haas, D, Hall, S, Hamzeh, F, Haubrich, R, Kashuba, A, Katzenstein, D, Lawrence, J, Lertora, J, Gerber, JG, Para, M, Rosenkranz, S, Sheiner, L, Wilkinson, G, Wood, AJJ, Wu, H, Morse, G, Aberg, J, Aweeka, F, Berry, M, Blaschke, T, Brundage, R & Christensen, R 2002, 'Position paper on therapeutic drug monitoring of antiretroviral agents', AIDS Research and Human Retroviruses, vol. 18, no. 12, pp. 825-834. https://doi.org/10.1089/08892220260190290
Acosta, Edward P. ; Fletcher, Courtney V. ; Flexner, Charles ; Haas, David ; Hall, Stephen ; Hamzeh, Fayez ; Haubrich, Richard ; Kashuba, Angela ; Katzenstein, David ; Lawrence, Jody ; Lertora, Juan ; Gerber, John G. ; Para, Michael ; Rosenkranz, Susan ; Sheiner, Lewis ; Wilkinson, Grant ; Wood, Alastair J J ; Wu, Hulin ; Morse, Gene ; Aberg, Judith ; Aweeka, Francesca ; Berry, Melissa ; Blaschke, Terrence ; Brundage, Richard ; Christensen, Rolf. / Position paper on therapeutic drug monitoring of antiretroviral agents. In: AIDS Research and Human Retroviruses. 2002 ; Vol. 18, No. 12. pp. 825-834.
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