Optimizing Drug Therapy Through Pharmacokinetics and Therapeutic Drug Monitoring

A Special Issue of Pharmaceutics (ISSN 1999-4923) belonging to the section "Pharmacokinetics and Pharmacodynamics".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 423

Editors


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Guest Editor
Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
Interests: population pharmacokinetics; pharmacodynamics; therapeutic drug monitoring; modeling & simulation

E-Mail Website
Guest Editor
Department of Pharmacy, Shimane University Hospital, 89-1 Enya, Izumo 693-8501, Japan
Interests: special population; population pharmacokinetic modeling; physiologically based pharmacokintic modeling; tissue penetration; pharmacodynamics; prediction of efficacy and toxicity; therapeutic drug monitoring

Special Issue Information

Dear Colleagues,

It is common knowledge that advances in individualized therapy have greatly contributed to improving drug treatment outcomes. Research on optimizing therapy through pharmacokinetic changes and therapeutic drug monitoring based on basic patient information, biomarkers and genetics has made remarkable progress and is expected to contribute greatly to future medical advances. In particular, high-quality evidence is desirable for special populations (e.g., pediatrics, pregnancy, obese, and dialysis), for which patient numbers are small and sampling is difficult. In recent years, there has been an increasing number of reports on optimizing therapy using mathematical models such as population pharmacokinetic models and physiologically based pharmacokinetic models, as well as utilizing artificial intelligence.

This Special Issue provides insights into individually optimized treatment based on pharmacokinetics and TDM, regardless of the field, including various domains such as anticancer, antimicrobial, cardiovascular, immunosuppressive and psychiatric drugs.

Dr. Kazuro Ikawa
Dr. Tetsushu Onita
Guest Editors

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Keywords

  • dosing optimization
  • therapeutic drug monitoring
  • pharmacokinetics
  • pharmacodynamics
  • modeling and simulation
  • special population

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Published Papers (1 paper)

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Research

19 pages, 1392 KB  
Article
Connecting the Dots Between Pharmacokinetics, Inflammatory Biomarkers, and Mucosal Healing in Patients on Infliximab with Inflammatory Bowel Disease
by Ana Homšek Ilić, Marija Jovanović, Srđan Marković, Sandra Vezmar Kovačević, Tamara Knežević Ivanovski, Petar Svorcan, Radojka Savić and Katarina Vučićević
Pharmaceutics 2026, 18(9), 1146; https://doi.org/10.3390/pharmaceutics18091146 - 11 Sep 2026
Abstract
Background/Objectives: Mucosal healing (MH) is a key therapeutic target in inflammatory bowel disease (IBD) associated with sustained remission, reduced hospitalisation, and improved outcomes. Its assessment relies on endoscopic evaluation, which is invasive, costly, and not always feasible. Therapeutic drug monitoring (TDM) of [...] Read more.
Background/Objectives: Mucosal healing (MH) is a key therapeutic target in inflammatory bowel disease (IBD) associated with sustained remission, reduced hospitalisation, and improved outcomes. Its assessment relies on endoscopic evaluation, which is invasive, costly, and not always feasible. Therapeutic drug monitoring (TDM) of infliximab (IFX) and evaluation of available biomarkers may provide non-invasive tools for predicting treatment response. This study investigated the association between IFX pharmacokinetics, routinely available blood biomarkers and MH to identify potential surrogates for predicting treatment outcomes. Methods: A monocentric, retrospective, real-world study was conducted, and pharmacokinetic analysis was performed in NONMEM version 7.5, applying a model with priors to estimate individual pharmacokinetic parameters. Endoscopic findings were collected, and patients were categorised according to achievement of MH. Univariate and multivariable logistic regression analyses were performed to evaluate the predictive value of tested variables, and receiver operating characteristic (ROC) curve analysis was performed to assess discriminative performance. Results: All evaluated variables demonstrated statistically significant associations with MH (p < 0.05). IFX clearance showed a strong inverse relationship with the probability of achieving MH. Leukocyte count exhibited particularly good discriminative ability, with an area under the ROC curve of 74.04% and an odds ratio of 0.78, highlighting its potential clinical utility. Multivariable logistic regression identified a model including IFX clearance and platelet count (PLT) as the most promising predictors of MH. Significant differences between patient subgroups indicated the association of higher PLT and modestly increased IFX clearance with a lower probability of MH. Conclusions: IFX clearance represents a promising surrogate marker for MH. TDM-derived parameters coupled with routinely available biomarkers may improve treatment response assessment. Combining pharmacokinetic and biomarker-based approaches could reduce reliance on repeated endoscopies while facilitating more effective IBD monitoring in clinical practice. Full article
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