Validation of a Capillary Dry Blood Sample MITRA-Based Assay for the Quantitative Determination of Systemic Tacrolimus Concentrations in Transplant Recipients
| Autor: | Imran Hussain, Ian Dawson, Gbenga Kazeem, Nassim Kamar, Nicholas Torpey, Swapneel Anaokar, Varuna Aluvihare, Nasrullah Undre, Faouzi Saliba |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty therapeutic drug monitoring Urology chemical and pharmacologic phenomena Focus Series: Alternative Sampling Strategies 030226 pharmacology & pharmacy Tacrolimus 03 medical and health sciences 0302 clinical medicine Therapeutic index LC–MS/MS medicine Humans Pharmacology (medical) Dosing Aged Pharmacology Kidney Venipuncture medicine.diagnostic_test business.industry Venous blood Middle Aged Kidney Transplantation MITRA microsampling device Transplant Recipients medicine.anatomical_structure surgical procedures operative Therapeutic drug monitoring Female Dried Blood Spot Testing Drug Monitoring business Immunosuppressive Agents Blood drawing transplantation Chromatography Liquid |
| Zdroj: | Therapeutic Drug Monitoring |
| ISSN: | 1536-3694 0163-4356 |
| Popis: | Background Tacrolimus is a narrow therapeutic index medication, which requires therapeutic drug monitoring to optimize dosing based on systemic exposure. MITRA microsampling offers a convenient, minimally invasive approach for the collection of capillary blood samples from a finger prick versus conventional venous blood sampling for quantitation of tacrolimus blood concentrations. However, the suitability of MITRA microsampling for the determination of tacrolimus concentrations requires assessment in clinical settings. Methods Paired venous (2 mL) and capillary (10 μL) blood samples were collected pre-tacrolimus dose and 1 and 3 hours postdose during routine outpatient visits from stable adult liver or kidney transplant patients receiving prolonged-release tacrolimus. Tacrolimus concentrations were determined by liquid chromatography-tandem mass spectrometry, and the concentrations obtained by the 2 sampling methods were compared by linear regression and Bland-Altman agreement analyses. Results Samples were available for 82 transplant recipients (kidney, n = 41; liver, n = 41). A high correlation was observed between tacrolimus concentrations in capillary and venous blood samples (Pearson correlation coefficient, 0.97; Lin concordance coefficient, 0.87; slope of the fitted line, >1.0). Tacrolimus concentrations in capillary samples were 22.5% higher on average than in the corresponding venous blood samples (95% limits of agreement, 0.5%-44.6%). Similar results were observed in both transplant subgroups. Conclusions MITRA finger prick sampling provides a convenient alternative to venipuncture for therapeutic drug monitoring in transplant recipients maintained on prolonged-release tacrolimus. When using the finger prick MITRA method, the positive bias in tacrolimus concentrations observed with this technique, when compared with venipuncture, needs to be taken into consideration. |
| Databáze: | OpenAIRE |
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