Dried Blood Microsampling-Based Therapeutic Drug Monitoring of Antiepileptic Drugs in Children With Nodding Syndrome and Epilepsy in Uganda and the Democratic Republic of the Congo
Velghe et al.
The finding, in our words
In children with epilepsy in remote African settings, dried blood microsampling enabled therapeutic drug monitoring but showed most patients had subtherapeutic antiepileptic drug concentrations. Volumetric absorptive microsampling gave inexplicably higher results than dried blood spots, and drug levels did not correlate with seizure control.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
This review summarises liquid chromatography with tandem mass spectrometry assays using dried blood spots and volumetric absorptive microsampling for quantifying antimicrobial drugs in children, highlighting that VAMS reduces haematocrit bias and offers a viable alternative to traditional plasma sampling for therapeutic drug monitoring.
The validated LC-MS/MS method showed similar pharmacokinetic profiles for albendazole and its metabolites across plasma, whole blood, dried blood spots and Mitra microsamples from hookworm-infected adolescents, supporting microsampling for paediatric pharmacokinetic studies. Mitra extraction proved more robust than dried blood spots during validation and is recommended for future albendazole pharmacokinetic work, despite higher albendazole sulfone concentrations observed in both microsampling devices compared with wet matrices.
A VAMS-LC-MS/MS method was developed and validated for measuring four antibiotics in 10 microlitres of human blood, showing that VAMS provided accurate quantification unaffected by haematocrit, unlike dried blood spots. The method was applied to paediatric patient samples, supporting its use for therapeutic drug monitoring in children.
An LC-MS/MS method accurately quantified hydroxyurea from small volumes of dried blood collected on DMPK-C cards and VAMS devices across a linear range of 0.5 to 60 μg/mL with comparable performance. This enables therapeutic drug monitoring and pharmacokinetic assessment in pediatric sickle cell anemia patients using capillary heel- or finger-prick sampling.
This review found that volumetric microsampling devices, such as Mitra, HemaPEN, HemaXis DB10, and Tasso-M20, overcome haematocrit bias, whilst Telimmune plasma separation cards enable direct plasma collection without centrifugation. These technologies support patient-centric, decentralised sampling, though the authors note that clinical validation remains limited across different drugs and patient populations.