Microsampling Devices for Routine Therapeutic Drug Monitoring-Are We There Yet?
Morgan
The finding, in our words
This review finds that sensitive assays and novel microsampling designs have largely overcome traditional dried blood spot limitations, establishing feasibility for routine therapeutic drug monitoring. Patient self-sampling remains uncommon but feedback is largely positive, indicating microsampling will become increasingly important in decentralised care.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
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.
This review surveys published LC-MS/MS methods that use dried blood microsampling for therapeutic drug monitoring of immunosuppressants in transplantation, chemotherapy and autoimmune disease, finding that volumetric dried blood samples can replace conventional venous draws for home sampling and improve patient quality of life. The authors discuss pre-analytical considerations, clinical applicability, cost-effectiveness, harmonisation gaps and patient perception, concluding that obstacles to routine clinical implementation remain despite growing methodological maturity.
Volumetric microsampling can enable patient-centred therapeutic drug monitoring with high patient preference and acceptable method validation for many drugs, but conversion from capillary to plasma and agreement with venous sampling varies by analyte and requires careful validation.
Home DBS sampling gave testosterone results that agreed well with venous blood in men on intramuscular testosterone undecanoate, but showed falsely high values in those using topical gel, likely from skin contamination. Patients preferred home collection for its convenience, suggesting DBS is viable for decentralised monitoring of injectable testosterone if patients are taught proper technique.
The HematoCARD cartridge autonomously collects duplicate 10 microlitre dried blood spot samples from a single finger prick and shows good analytical performance for monitoring adalimumab, with accuracy between 91 and 111 per cent, linearity R squared 0.99 and coefficient of variation at or above 0.94 compared with serum reference and commercial DBS microsampling methods.