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

Thierry P. I. J. M. Canisius, J. W. P. Hans Soons*, Pauline Verschuure, Emmeke A. Wammes-van der Heijden, Rob P. W. Rouhl, H. J. Marian Majoie

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Web of Science)

Abstract

Background: Therapeutic drug monitoring (TDM) of antiepileptic drugs (AEDs) can serve as a valuable tool in optimising and individualising epilepsy treatment, especially in vulnerable groups such as pregnant women, the elderly and children. Unfortunately, TDM is often performed suboptimally due to limitations in blood collection. Therefore, we investigated volumetric absorptive micro sampling (VAMS) - a new home-sampling technique. We aimed to evaluate VAMS to determine and quantify the different AEDs and concentrations of 16 different AEDs in whole blood collected by VAMS.

Methods: Patient blood samples (n = 138) were collected via venepunctures at the Academic Centre for Epileptology Kempenhaeghe. AED concentrations were determined, and these concentrations were used to compare the VAMS method (whole blood) with the conventional method (serum). In addition, the recovery was examined as well as the impact of haematocrit. Finally, AED-spiked blood was used to test the stability of the AEDs inside the micro-sampler devices over a period of time and whether temperature had an effect on the stability.

Results: VAMS allows for an accurate detection of 16 different AEDs within 2 days after sampling. Deviation in recovery was less than 10% and high correlations were found between VAMS and conventional sampling. Moreover, haematocrit does not have an effect with values between 0.3 and 0.5 (L/L). Finally, although storage temperature of VAMS does affect some AEDs, most are unaffected.

Conclusions: VAMS enables an accurate detection of a wide variety of AEDs within 2 days after sampling.

Original languageEnglish
Pages (from-to)828-835
Number of pages8
JournalClinical Chemistry and Laboratory Medicine
Volume58
Issue number5
DOIs
Publication statusPublished - May 2020

Keywords

  • anti-epileptic drugs
  • therapeutic drug monitoring
  • volumetric absorptive micro sampling
  • EPILEPSY

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