TDM is dead. Long live TCI!
Nicholas H. G. Holford, Guangda Ma, David Metz
Abstract
Twenty years ago, target concentration intervention (TCI) was distinguished from therapeutic drug monitoring (TDM). It was proposed that TCI would bring more clinical benefit because of the precision of the approach and the ability to link TCI to principles of pharmacokinetics and pharmacodynamics to predict the dose required by an individual (1). We examine the theory and clinical trial evidence supporting the benefits of TCI over TDM and conclude that in the digital age TDM should be abandoned and replaced by TCI.
Topics & Concepts
Therapeutic drug monitoringPharmacodynamicsPharmacokineticsMedicinePharmacologyAntibiotics Pharmacokinetics and EfficacyPharmacogenetics and Drug MetabolismEpilepsy research and treatment