Tacrolimus and sirolimus in capillary dried blood spots allows for remote monitoring

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 and parallel-reaction-monitoring mass spectrometry for tacrolimus trough measurements at home in paediatric heart-transplant patients — Zhao et al., J. Mass Spectrometry and Advances in the Clinical Lab · source ↗

• vams
• venous-agreement
• acceptability
• blood
• dbs
• tdm
• self-collection
• dried
• capillary
• pediatric
• immunosuppressants
• validation

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.

Patient-centric capillary dried blood spot sampling for tacrolimus and creatinine monitoring in clinical practice — De Baets et al., Clinical chemistry and laboratory medicine (paywalled) · source ↗

• blood
• dried
• capillary
• dbs
• qdbs
• self-collection
• venous-agreement
• acceptability
• tdm
• immunosuppressants

Clinical validation for tacrolimus and mycophenolic acid monitoring showed that while volumetric absorptive microsampling met analytical criteria after concentration correction, conventional dried blood spots achieved superior adherence to strict clinical criteria, sample quality, and cost efficiency without significant haematocrit bias.

Comparison of conventional dried blood spots and volumetric absorptive microsampling for tacrolimus and mycophenolic acid determination — Paniagua-González et al., Journal of pharmaceutical and biomedical analysis (paywalled) · source ↗

• blood
• dried
• capillary
• vams
• dbs
• neoteryx-mitra
• self-collection
• validation
• venous-agreement
• tdm
• immunosuppressants
• economics
• haematocrit

A systematic review of dried blood spot sampling for tacrolimus monitoring across adult and paediatric organ transplant recipients demonstrated that reported analytical bias compared with venous sampling fell within acceptable limits across the majority of studies. This supports dried blood microsampling as an accurate approach for decentralised therapeutic drug monitoring.

Predictability of Capillary Blood Spot Toward Venous Whole Blood Sampling for Therapeutic Drug Monitoring of Tacrolimus in Solid Organ Transplant Recipients — Gallant et al., European journal of drug metabolism and pharmacokinetics (paywalled) · source ↗

• blood
• dried
• capillary
• dbs
• validation
• venous-agreement
• pediatric
• tdm
• immunosuppressants

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.

Dried Blood Spot Self-Sampling by Guardians of Children With Epilepsy Is Feasible: Comparison With Plasma for Multiple Antiepileptic Drugs — Linder et al., Therapeutic drug monitoring (paywalled) · source ↗

• blood
• liquid
• dried
• capillary
• dbs
• self-collection
• validation
• venous-agreement
• pediatric
• tdm