Application of therapeutic drug monitoring in immunosuppressant treatment of rheumatism

Rheumatism is a group of diseases primarily characterized by chronic inflammation or pain in the joints, muscles, and bones. The etiology is complex, and the disease processes are protracted and are often accompanied by immune system disorders. Immunosuppressive drugs are widely used in the treatment of rheumatism because they can effectively suppress the overreaction of the immune system, thus reducing inflammation and autoimmune damage. However, as the immunosuppressive drugs have narrow therapeutic window and exhibit significant individual variations, they carry a high risk of severe adverse effects such as hepatorenal damage and infection while controlling the disease. Therapeutic drug monitoring (TDM) optimizes treatment regimens by monitoring the drug concentration in patient body fluids, thereby enhancing efficacy and reducing the incidence of adverse effects. This article reviews the types of immunosuppressants used in the treatment of rheumatism, the advances in TDM technology and relevant research progress in rheumatism, aiming to improve doctors’ understanding and attention to this technology.