Managing the IBD Patient: Proactive Therapeutic Drug Monitoring – Pretest

1. Please list your last name and zip code:

2. What is your specialty?

3. How many patients with IBD do you see each week?

4. The 2017 AGA guidelines recommend therapeutic drug monitoring (TDM) in which of the following situations?

5. Your patient, a 23-year-old male with a new diagnosis of moderate-to-severe Crohn’s colitis, was started on prednisone 40mg and infliximab 5mg/kg. He did well during induction dose; however, after tapering off prednisone, his symptoms recur and fecal calprotectin is 300 on infliximab 5mg/kg every 8 weeks. His infliximab trough level at week 14 is 18 mcg/ml and there are no anti-drug antibodies. C. difficile is negative. What is the next best step?