Dried Blood Spot Self-Sampling by Guardians of Children With Epilepsy Is Feasible: Comparison With Plasma for Multiple Antiepileptic Drugs
Linder et al.
The finding, in our words
Guardian-collected capillary dried blood spots were feasible for home monitoring of lamotrigine, and for carbamazepine and valproic acid when conversion factors were applied, with only 4 of 190 comparisons risking a conflicting dose decision and negligible risk of patient harm. Levetiracetam DBS showed high variability against plasma and is recommended only for checking nonadherence, not for dose adjustment.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
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 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 dried blood spot LC-MS/MS method was validated for therapeutic monitoring of carbamazepine, lamotrigine, levetiracetam and valproic acid. Concentrations from dried blood spots correlated strongly with plasma (R² 0.92) across venous and capillary samples, enabling home self-collection and reducing clinic visits for children with epilepsy.
Dried VAMS and DBS samples collected at home and analysed after a median of three days showed poor agreement with standard venous or capillary blood for HbA1c monitoring. In contrast, wet VAMS samples analysed immediately demonstrated excellent agreement, indicating that sample drying and delayed analysis compromise reliability for decentralised HbA1c measurement.
In AML and CLL, 91% of VAMS venetoclax results fell within 20% of plasma after individualised haematocrit correction; in home sampling, 18 of 21 patients self-sampled independently and 76% of returned samples were analysable, which shows home microsampling is workable, though the authors ask for multicentre validation.