Concentration Guided Dosing

Individualized dosing for treatment of human disease takes many forms. Dosing based on pharmacological principles recognizes that drug effects are caused by drug concentration not dose. Concentration guided dosing (CGD) encompasses a variety of approaches that are based on pharmacokinetic and pharmacodynamic concepts even though these concepts may not be explicitly recognized. CGD may be based on similar patient information including measured patient responses such drug concentrations but approaches for using these responses to determine an individualized dose have different clinical outcomes.The two most common approaches are therapeutic drug monitoring (TDM) and target concentration intervention (TCI). TDM is based on achieving a response within a range (the therapeutic window) while TCI is based on achieving a single target response. Clinical studies have shown that TCI can improve clinical outcome while TDM does not (Holford, Ma, Metz 2020).The webinar will explain the concept of concentration guided dosing and illustrate the superiority of the TCI approach over the TDM approach.Holford N, Ma G, Metz D. TDM is dead. Long live TCI! Br J Clin Pharmacol. 2020;Early View(doi:10.1111/bcp.14434).