Baldelli Sara, Castoldi Simone, Charbe Nitin, Cozzi Valeria, Fucile Serena, Cattaneo Dario, Clementi Emilio
*Unit of Clinical Pharmacology, Luigi Sacco University Hospital, Milan; †Clinical Pharmacology Unit, Consiglio Nazionale delle Ricerche Institute of Neuroscience, Department of Biomedical and Clinical Sciences, Luigi Sacco University Hospital, Università degli Studi di Milano, Milan; and ‡Eugenio Medea Scientific Institute, Bosisio Parini, Italy.
Ther Drug Monit. 2015 Oct;37(5):689-94. doi: 10.1097/FTD.0000000000000202.
Recently, a turbidimetric immunoassay method has been developed for use in the form of a QMS lamotrigine (LTG) commercial immunoassay. This study was designed to evaluate the performance of this immunoassay using a validated high-performance liquid chromatography-ultraviolet (HPLC-UV) method as the reference.
The performance of QMS was initially tested using drug-free plasma spiked with different amounts of LTG and, subsequently, by analyzing 61 trough plasma samples from epileptic patients given the drug as part of their maintenance antiepileptic therapies.
The correlation between LTG concentrations measured by QMS and HPLC was good, with a Pearson coefficient of 0.968 (P < 0.0001). The Bland-Altman approach showed that LTG concentrations measured with QMS exceeded HPLC on an average by 15.6% (limits of agreement, -18% to +63%), with a concentration-dependent performance (mean percent bias, 49.5 ± 8.2% and 0.6 ± 12.7% for concentrations less than 2 mg/L and greater than 14.9 mg/L, respectively).
The QMS provided acceptable analytical performance across a wide concentration range for routine LTG measurements, being at least comparable with the other commercial immunoassays. It could be, therefore, considered as a viable alternative to HPLC methods for routine LTG monitoring in the clinical practice, although its suitability for accurate analysis of samples with low concentration is limited.
最近,一种比浊免疫分析法已被开发出来,用于QMS拉莫三嗪(LTG)商业免疫测定形式。本研究旨在以经过验证的高效液相色谱 - 紫外(HPLC - UV)法作为参考,评估这种免疫测定法的性能。
首先使用添加不同量LTG的无药血浆对QMS的性能进行测试,随后,通过分析61例癫痫患者在维持抗癫痫治疗期间的谷浓度血浆样本进行测试。
QMS测定的LTG浓度与HPLC测定结果之间具有良好的相关性,Pearson系数为0.968(P < 0.0001)。Bland - Altman方法显示,QMS测定的LTG浓度平均比HPLC测定结果高15.6%(一致性界限为 - 18%至 +63%),具有浓度依赖性性能(浓度小于2 mg/L和大于14.9 mg/L时,平均偏差百分比分别为49.5 ± 8.2%和0.6 ± 12.7%)。
QMS在较宽的浓度范围内为常规LTG测量提供了可接受的分析性能,至少与其他商业免疫测定法相当。因此,在临床实践中,它可被视为HPLC方法用于常规LTG监测的可行替代方法,尽管其对低浓度样本进行准确分析的适用性有限。