Laboratory Clinical Chemistry and Pharmacology, Academic Centre for Epileptology Kempenhaeghe Maastricht UMC+, VE Heeze, the Netherlands.
Department of Neurology, Academic Centre for Epileptology Kempenhaeghe Maastricht UMC+, Heeze, the Netherlands.
Clin Chem Lab Med. 2020 Apr 28;58(5):828-835. doi: 10.1515/cclm-2019-0784.
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.
治疗药物监测（TDM）可作为优化和个体化癫痫治疗的有价值的工具，尤其适用于孕妇、老年人和儿童等弱势群体。不幸的是，由于采血限制，TDM 的实施往往并不理想。因此，我们研究了容量吸收微采样（VAMS）——一种新的家庭采样技术。我们旨在评估 VAMS，以确定和量化通过 VAMS 采集的全血中的不同抗癫痫药物（AED）及其浓度。
通过静脉穿刺从学术癫痫中心 Kempenhaeghe 采集患者血样（n=138）。测定 AED 浓度，并将这些浓度用于比较 VAMS 方法（全血）与传统方法（血清）。此外，还检查了回收率以及血细胞比容的影响。最后，使用添加 AED 的血液来测试在一段时间内 AEDs 在微采样器装置内的稳定性，以及温度是否对稳定性有影响。
VAMS 可在采样后 2 天内准确检测 16 种不同的 AED。回收率的偏差小于 10%，VAMS 和传统采样之间存在高度相关性。此外，血细胞比容在 0.3 至 0.5（L/L）之间没有影响。最后，尽管 VAMS 的储存温度会影响某些 AED，但大多数 AED 不受影响。
VAMS 可在采样后 2 天内准确检测多种 AED。
