Promising Tools to Facilitate the Implementation of TDM of Biologics in Clinical Practice
Soenen et al.
The finding, in our words
In a small substudy of psoriasis patients, lateral flow testing for adalimumab agreed very well with ELISA (r=0.95, R2=0.89) and capillary VAMS from finger prick correlated strongly with serum (r=0.87), while patients found home microsampling acceptable, indicating promise for decentralised TDM of biologics and warranting larger validation.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
At-home volumetric absorptive microsampling (VAMS) for anti-seizure medicines was feasible and reliable, with strong correlations to clinic VAMS and low bias for lacosamide, lamotrigine and levetiracetam; quantitative dried blood spot (qDBS) was a reliable alternative in the ambulatory setting, though older age reduced sampling quality.
Cancellerini et al., Epilepsia (paywalled) · source ↗
This study established conversion methods for estimating plasma concentrations from whole blood VAMS samples for seven out of ten oral anticancer drugs, finding good agreement between capillary and venous samples. Patients reported a positive experience with home sampling using this microsampling technique.
Meertens et al., Therapeutic drug monitoring · 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 ↗
VAMS matched serum for the kinase inhibitors nilotinib, cabozantinib, dabrafenib and ruxolitinib, r 0.94–0.97, with serum reliably predictable for the first three, and 93% of at-home samples were collected correctly: at-home VAMS shown feasible for routine cancer-drug monitoring.
Zimmermann et al., J. Pharmaceutical and Biomedical Analysis (paywalled) · source ↗
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.
Levens et al., Clinical Pharmacokinetics (paywalled) · source ↗