Comparison between dried blood spot and plasma sampling for therapeutic drug monitoring of antiepileptic drugs in children with epilepsy: A step towards home sampling
Linder et al.
The finding, in our words
This study in children with epilepsy demonstrated strong correlation between dried blood spot and plasma concentrations for carbamazepine, lamotrigine and valproic acid. While lamotrigine concentrations were directly comparable, conversion factors were required for carbamazepine (18% higher bias) and valproic acid (35% lower bias), supporting the feasibility of home sampling for therapeutic drug monitoring and its potential to simplify care and reduce costs.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
The authors validated a UPLC-PDA assay for ceftazidime in 10 microlitre dried blood spots collected with the Capitainer device from neonatal patients, achieving accuracy of 90.1 to 104.8 per cent and precision within 11.7 per cent coefficient of variation across a quantification range of 0.5 to 200 micrograms per millilitre, and confirmed the method worked on clinical neonatal samples. This supports microsampling-based therapeutic drug monitoring of an antimicrobial in a vulnerable population where conventional venous blood draws are difficult.
A validated high-throughput LC-MS/MS assay for piperaquine from dried blood spots achieved 54-72% recovery with <9% relative standard deviation and a quantification limit of 3 ng/mL, enabling detection for 4-8 weeks post-dose. The method showed minimal haematocrit interference and is suitable for therapeutic drug monitoring of antimalarial treatment in resource-limited settings and pediatric populations.
VAMS microsampling found no significant difference from venous blood for tacrolimus in paediatric patients; samples were stable for 14 days, with average difference between paired at-home samples of 0.12 ± 0.94 ng/mL.
The dried blood spot method via fingerprick showed greater variability than venipuncture for antipsychotic drug concentrations but was feasible in children and adolescents with behavioural problems, and higher risperidone trough concentrations correlated with both increased weight gain and greater effectiveness, enabling definition of a therapeutic window for safer dosing in this population.
A systematic review of dried blood spot sampling for tacrolimus monitoring across adult and paediatric organ transplant recipients demonstrated that reported analytical bias compared with venous sampling fell within acceptable limits across the majority of studies. This supports dried blood microsampling as an accurate approach for decentralised therapeutic drug monitoring.