Volumetric Absorptive Microsampling to Enhance the Therapeutic Drug Monitoring of Tacrolimus and Mycophenolic Acid: A Systematic Review and Critical Assessment
Leino et al.
The finding, in our words
The review found that volumetric absorptive microsampling can reliably assay tacrolimus and mycophenolic acid for therapeutic drug monitoring, though correction factors are often required to meet regulatory agreement standards. This supports the use of microsampling for decentralised trials and dose optimisation in transplant recipients.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
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.
Juan et al., Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques · source ↗
In matched clinical samples from rheumatoid arthritis, VAMS and DBS showed strong agreement for methotrexate polyglutamates (slopes 0.95-1.07; bias within -4.21% to 0.36%; SRCC ≥ 0.969), with up to 100% of total MTXPG results within ±20% limits; capillary microsampling agreed closely with whole blood but differed from red blood cells, indicating matrix-specific differences that must be accounted for when interpreting against RBC-based reference values.
Kocur et al., International journal of molecular sciences · source ↗
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.
A validated offline SPE-LC-MS/MS method using the Mitra microsampling device successfully quantified tacrolimus, cyclosporine A, tryptophan, kynurenine, and creatinine simultaneously. The method met EMA and FDA criteria, showing agreement between capillary and venous sampling, which could facilitate decentralised therapeutic drug monitoring and transplant follow-up through patient self-collection.
Nierychlewski et al., Therapeutic drug monitoring · source ↗