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However, the clinical experience with monoclonal antibodies (MAbs) following approval has been less than perfect. In inflammatory diseases, the disease burden changes with time and high treatment failure rates have been reported. In addition, the use of concomitant steroids and immunosuppressant drugs with MAbs is common. These concomitant agents have their own safety issues and many immunosuppressant agents are not well\u2010tolerated although they have been shown to reduce the incidence of anti\u2010drug antibodies (ADA). This same complexity is seen in MAbs used in oncology as well, although with these agents the doses appear to be higher than needed, which results in high treatment costs and incidence of adverse events. Given the complexity of MAb pharmacokinetics, which makes providing a detailed description of dose options difficult, product labeling should include the options for alternative dose strategies and potentially include the use of therapeutic drug monitoring with dose individualization which have been shown to improve clinical response and reduce the incidence of ADA. So, while the recommended dosing for biologics seems improved over the issues noted 17\u2009years ago, we still have some work to do.<\/jats:p>","DOI":"10.1002\/cpt.3285","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T06:43:10Z","timestamp":1714372990000},"page":"613-618","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["\u201cGetting the Dose Right\u201d\u2014Revisiting the Topic With Focus on Biologic Agents"],"prefix":"10.1002","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8908-0136","authenticated-orcid":false,"given":"Diane R.","family":"Mould","sequence":"first","affiliation":[{"name":"Projections Research Inc  Phoenixville Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9996-4886","authenticated-orcid":false,"given":"Richard N.","family":"Upton","sequence":"additional","affiliation":[{"name":"Projections Research Inc  Phoenixville Pennsylvania USA"},{"name":"Clinical and Health Sciences University of South Australia  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,28]]},"reference":[{"key":"e_1_2_12_1_1","unstructured":"Debus A.G.\u201cParacelsus and the medical revolution of the renaissance\u201d\u2014A 500th Anniversary Celebration from the National Library of Medicine 3 (1993)."},{"key":"e_1_2_12_2_1","unstructured":"\"Paracelsus\" Britannica<https:\/\/www.britannica.com\/biography\/Paracelsus>. 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