Concentration Guided Dosing

Nick Holford, MB, ChB, MSc, FRACP,

Professor Emeritus Clinical Pharmacology, Department of Pharmacology and 
Clinical Pharmacology, University of Auckland, New Zealand

Wednesday March 16, 2022, 12:00 to 1:00 pm EDT

Register for free at 
https://www.rosaandco.com/webinars/2022/concentration-guided-dosing

Abstract:

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 pharmacodynamics 
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).

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