Eight Drugs a Week, Episode 5 – TDM of antiretroviral drugs: The continuing story (of Bungalow Bill)…

This episode is about the TDM of antiretroviral drugs, an area with a boom in research output in the late 90s and early 2000s, generating enough randomized controls trials for a substantial systematic Cochrane review on the topic (a rare thing for TDM research!). It’s an ever-evolving space, but we have learned a lot through concentration monitoring, and TDM continues to be very useful in optimizing treatment. As our title suggests, this is a continuing story, and our guests, Natella Rakhmanina and Dario Cattaneo, have both been closely involved with it over their careers.

In this episode we hear about:

• The usefulness and limitations of using TDM to monitor adherence.
• Diverse niche patient scenarios where TDM can be very helpful, which are not at all uncommon.
• Interesting challenges where TDM can be helpful, some that are particular to paediatric patients, and others to elderly HIV patients.
• Learnings from TDM for long-acting drugs in psychiatry, and the implications for novel depot antiretroviral formulations.
• Drug interaction attributable to antiretrovirals, and those that affect them.
• Why, despite viral monitoring, TDM for antiretrovirals can still be very useful.
• What Paxlovid tastes like.

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About our guests:

Natella Rakhmanina is a Professor at the Department of Pediatrics, School of Medicine and Health Sciences of The George Washington University. She is also director of HIV Services of the Division of Infectious Diseases at the Children’s National Hospital in Washington.

Dario Cattaneo is currently the President of the IATDMCT. He is a clinical pharmacologist at Luigi Sacco University Hospital in Milan and an Adjunct Professor at the University of Milan, Italy.