Methotrexate polyglutamates as a potential marker of adherence to long-term therapy in children with juvenile idiopathic arthritis and juvenile dermatomyositis: an observational, cross-sectional study
Hawwa et al.
The finding, in our words
Dried blood spots from finger-pricks, collected either in clinic or by families at home, showed wide fluctuations in methotrexate levels in 17 of 48 children with juvenile arthritis or dermatomyositis, indicating nonadherence. Younger age and oral administration predicted poorer adherence, while subcutaneous dosing gave higher drug concentrations, proving that decentralised therapeutic drug monitoring is feasible in paediatric patients.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
A systematic review found mixed economic evidence for microsampling in therapeutic drug monitoring; one study reported no cost reduction with DBS home-sampling, €688 versus €676, whilst another predicted savings up to 61%. The authors caution that more work is required to assess costs alongside clinical outcomes and optimise logistics for decentralised implementation.
Carland et al., British Journal of Clinical Pharmacology (paywalled) · source ↗
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.
Zhao et al., J. Mass Spectrometry and Advances in the Clinical Lab · source ↗
Capillary dried blood spots collected at home by pediatric transplant patients and mailed to the laboratory gave tacrolimus and sirolimus results that were clinically comparable to venous whole blood, with small negative biases within acceptable limits, enabling remote therapeutic drug monitoring.
Dickerson et al., Pediatric transplantation (paywalled) · source ↗
Enhanced visual and textual guidance significantly improved the quality of dried blood spots self-collected by children and adolescents, increasing the proportion of acceptable cards from 47.6% to 86.6%, which supports the feasibility of home sampling for therapeutic drug monitoring.
Ringeling et al., Therapeutic drug monitoring · source ↗
The study found that quantitative dried blood spot sampling provided high clinical agreement for tacrolimus and creatinine monitoring, with patients rating the self-collection devices as user-friendly. These results support the feasibility of decentralised therapeutic drug monitoring for immunosuppressants.
De Baets et al., Clinical chemistry and laboratory medicine (paywalled) · source ↗