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Optimization of anti-TNF therapy:
The role of combination therapy and therapeutic drug monitoring in the clinic


Raymond Cross, MD, MS, AGAF
Associate Professor of Medicine
Director, IBD Program
University of Maryland School of Medicine
Co-Director, Digestive Health Center
University of Maryland Medical Center
Baltimore, MD



This hot topic will provide an overview of strategies to optimize therapy in a 'new' anti-TNF patient, including the role of therapeutic drug monitoring and combination therapy.

This activity has been designed to meet the educational needs of gastroenterologists and registered nurses involved in the care of patients with inflammatory bowel disease (IBD).

Release date: October 20, 2015

Learning objectives

After completing this activity, the participant should be better able to:

  • Identify prognostic factors associated with a more severe disease course in patients with Crohn's disease
  • Evaluate which patients with Crohn's disease should receive a combination of immune suppressant and anti-TNF in clinical practice
  • Describe how to implement therapeutic drug levels in patients with Crohn's disease in clinical practice
  • Discuss when to stop immune suppressant or anti-TNF therapy in patients with Crohn's disease
  • Provide appropriate care and counsel for patients and their families.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

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