Area Under the Curve-Guided Therapeutic Drug Monitoring of Mycophenolic Acid in Lung Transplant Recipients: Volumetric Absorptive Microsampling and Population Pharmacokinetic-Based Limited Sampling Strategies
Juan et al.
The finding, in our words
In a prospective cohort of nine lung transplant recipients, VAMS based limited sampling strategies accurately predicted full profile mycophenolic acid exposure, supporting simplified AUC guided therapeutic drug monitoring; however, exploratory population pharmacokinetic findings require validation in larger cohorts.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
In lung and renal transplant recipients, VAMS sampling with LC-MS/MS quantification of mycophenolic acid and tacrolimus showed good linearity and accuracy, and with a haematocrit-adjusted conversion formula achieved clinical agreement in most samples; tacrolimus did not require haematocrit correction. The approach is virtually painless and enables richer sampling for more accurate drug exposure estimates, supporting decentralised therapeutic drug monitoring.
Juan et al., Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques · source ↗
In matched clinical samples from rheumatoid arthritis, VAMS and DBS showed strong agreement for methotrexate polyglutamates (slopes 0.95-1.07; bias within -4.21% to 0.36%; SRCC ≥ 0.969), with up to 100% of total MTXPG results within ±20% limits; capillary microsampling agreed closely with whole blood but differed from red blood cells, indicating matrix-specific differences that must be accounted for when interpreting against RBC-based reference values.
Kocur et al., International journal of molecular sciences · source ↗
Dried saliva collected with the Mitra device correlated strongly with wet saliva but poorly with plasma unbound and total concentrations, indicating it is not a reliable substitute for plasma in routine therapeutic drug monitoring of mycophenolic acid and its glucuronide metabolite. Capillary blood collected via VAMS remains a promising alternative for long term monitoring in paediatric patients.
A validated LC-MS/MS method for everolimus using Mitra and Capitainer devices found excellent agreement between capillary microsamples and venous whole blood in 33 adult transplant recipients. The results showed high accuracy and negligible haematocrit effects, supporting the use of microsampling for decentralised therapeutic drug monitoring.
A validated offline SPE-LC-MS/MS method using the Mitra microsampling device successfully quantified tacrolimus, cyclosporine A, tryptophan, kynurenine, and creatinine simultaneously. The method met EMA and FDA criteria, showing agreement between capillary and venous sampling, which could facilitate decentralised therapeutic drug monitoring and transplant follow-up through patient self-collection.
Nierychlewski et al., Therapeutic drug monitoring · source ↗