Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA.
Section of Clinical Chemistry, Division of Laboratory Medicine, Department of Pathology, Texas Children's Hospital, Houston, TX, USA.
J Clin Lab Anal. 2021 Aug;35(8):e23796. doi: 10.1002/jcla.23796. Epub 2021 Jun 19.
Eltrombopag is a thrombopoietin-receptor agonist used to restore platelet count to hemostatic levels in chronic immune thrombocytopenia. The drug has shown to have hepatobiliary adverse effects, but also positive interference with the analytical measurement of bilirubin. Understanding the degree of interference of this drug with bilirubin testing becomes relevant in the clinical management of these patients.
Eltrombopag at concentrations ranging from 10 to 150 µg/ml was spiked into plasma samples with different baseline concentrations of bilirubin. Total bilirubin, conjugated, and unconjugated bilirubin were measured for each sample using VITROS TBILI and BuBc slides on the Vitros 5600 automated chemistry platform, and interference was assessed.
Plasma samples spiked with eltrombopag yielded falsely elevated bilirubin measurements compared to baseline, with the degree of elevation increasing with greater concentrations of eltrombopag. Bilirubin values were increased relative to baseline across all groups, except in conjugated bilirubin measurements in samples with low baseline conjugated bilirubin. For samples with low total bilirubin at baseline, >100 µg/ml of eltrombopag resulted in an error of >+0.6 mg/dl on the measured total bilirubin. For samples with low unconjugated bilirubin at baseline, the error for the same concentrations was >+0.7 mg/dl.
Our results show that, at supra-physiologically high concentrations, eltrombopag can positively interfere with bilirubin measurements on Vitros 5600 platform.
艾曲波帕是一种血小板生成素受体激动剂，用于将慢性免疫性血小板减少症患者的血小板计数恢复到止血水平。该药物已显示出肝胆不良影响，但也会对胆红素的分析测量产生正干扰。了解该药对胆红素检测的干扰程度在这些患者的临床管理中变得相关。
将艾曲波帕浓度范围为 10 至 150μg/ml 加入到不同胆红素基线浓度的血浆样本中。使用 VITROS TBILI 和 BuBc 载片在 Vitros 5600 自动化化学平台上测量每个样本的总胆红素、结合胆红素和未结合胆红素，并评估干扰。
与基线相比，添加艾曲波帕的血浆样本产生了假性升高的胆红素测量值，随着艾曲波帕浓度的增加，升高程度增加。与基线相比，除了基线结合胆红素低的样本中的结合胆红素测量值外，所有组的胆红素值都增加。对于基线总胆红素低的样本，>100μg/ml 的艾曲波帕会导致测量总胆红素的误差>+0.6mg/dl。对于基线未结合胆红素低的样本，相同浓度的误差>+0.7mg/dl。
我们的结果表明，在超生理高浓度下，艾曲波帕可对 Vitros 5600 平台上的胆红素测量产生正干扰。
