Real-world evaluation of capillary microsampling for drug monitoring of anti-seizure medications
Cancellerini et al.
The finding, in our words
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.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
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.
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.
Microsampling, particularly VAMS and quantitative DBS, can enable patient-centric therapeutic drug monitoring of immunosuppressants after transplantation, allowing home self-sampling and long-term monitoring when patients live far from transplant centres. These volumetric dried formats have largely overcome the haematocrit effect and sample heterogeneity that limit conventional dried blood spots.
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.
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.