Therapeutic drug monitoring of anti-epileptic drugs - a clinical verification of volumetric absorptive micro sampling

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.

Clinical Validation of Venetoclax Volumetric Microsampling in Leukemia, with Whole-Blood-to-Plasma Conversion and Self-Microsampling Feasibility — Levens et al., Clinical Pharmacokinetics (paywalled) · source ↗

• vams
• venous-agreement
• blood
• dbs
• tdm
• self-collection
• haematocrit
• dried
• oncology
• capillary
• validation

In lung and renal transplant recipients, VAMS sampling with LC-MS/MS quantification of mycophenolic acid and tacrolimus showed good linearity and accuracy, and with a haematocrit-adjusted conversion formula achieved clinical agreement in most samples; tacrolimus did not require haematocrit correction. The approach is virtually painless and enables richer sampling for more accurate drug exposure estimates, supporting decentralised therapeutic drug monitoring.

Evaluation of hematocrit-adjusted conversion strategies for mycophenolic acid and tacrolimus monitoring using volumetric absorptive microsampling in lung and renal transplant recipients — Juan et al., Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques · source ↗

• blood
• dried
• vams
• neoteryx-mitra
• validation
• venous-agreement
• tdm
• immunosuppressants
• haematocrit

The study validated an LC-MS/MS method for eight antiepileptic drugs and two metabolites in dried blood spot and VAMS formats, with satisfactory analytical performance and stability, and was the first to include the oxcarbazepine metabolite DHCB. In 80 paired patient samples, microsampling concentrations showed promising correlation with plasma, supporting decentralised therapeutic drug monitoring of antiepileptic treatment.

Development and application of an LC-MS/MS method for 8 antiepileptic drugs and 2 metabolites using microsampling techniques (DBS and VAMS) — Cobo-Golpe et al., Journal of analytical toxicology · source ↗

• blood
• dried
• vams
• dbs
• neoteryx-mitra
• validation
• venous-agreement
• tdm
• haematocrit

A UPLC-MS/MS method for linezolid and metabolites in oral fluid and VAMS capillary blood satisfied ICH M10 validation requirements. Linezolid concentrations correlated strongly with venous plasma in both matrices, offering a non‑invasive option for therapeutic drug monitoring, whereas metabolites were systematically underestimated in VAMS and seldom detectable in oral fluid, restricting metabolite measurement.

Simultaneous quantification of linezolid and its metabolites (PNU-142300 and PNU-142586) in oral fluid and capillary blood by UPLC-MS/MS: method validation and clinical application using non-invasive sampling techniques — González-Berdullas et al., Journal of translational medicine (paywalled) · source ↗

• blood
• saliva
• dried
• capillary
• vams
• validation
• venous-agreement
• tdm
• antimicrobials
• haematocrit

A validated LC-MS/MS method for everolimus using Mitra and Capitainer devices found excellent agreement between capillary microsamples and venous whole blood in 33 adult transplant recipients. The results showed high accuracy and negligible haematocrit effects, supporting the use of microsampling for decentralised therapeutic drug monitoring.

Therapeutic Drug Monitoring of Everolimus Using Volumetric Absorptive Microsampling and Quantitative Dried Blood Spot Methods with LC-MS/MS in Adult Solid Organ Transplant Recipients: An Analytical and Clinical Comparative Study — Kocur et al., Molecules · source ↗

• vams
• venous-agreement
• neoteryx-mitra
• blood
• qdbs
• tdm
• haematocrit
• dried
• capillary
• immunosuppressants
• validation