We thank the authors for their comments regarding the American Gastroenterological Association (AGA) guidelines on therapeutic drug monitoring. The AGA’s clinical guideline development follows the Institute of Medicine’s 8 standards for developing rigorous, trustworthy clinical practice guidelines, and uses the GRADE framework to judge the quality of evidence and strength of recommendations, to provide a clear and actionable direction to clinicians, patients, and policymakers.1 In the therapeutic drug monitoring guidelines, the statement of “no recommendation” regarding routine, proactive therapeutic drug monitoring in patients with quiescent disease (no objective evidence of active inflammation, regardless of gastrointestinal symptoms) was based on a thorough, unbiased, and objective review of all available evidence and a balanced view of desirable and undesirable potential downstream consequences of testing when applied to the entire community of gastroenterologists.