Grześk Grzegorz, Stolarek Wioleta, Kasprzak Michał, Grześk Elżbieta, Rogowicz Daniel, Wiciński Michał, Krzyżanowski Marek
Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum, Nicolaus Copernicus University, Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland.
Department of Pharmacology and Therapeutics, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland.
J Clin Med. 2021 Nov 19;10(22):5396. doi: 10.3390/jcm10225396.
Carbamazepine (CBZ) is a first-generation anticonvulsant drug. Hence, in certain cases, therapeutic drug monitoring (TDM) supports pharmacotherapy.
The presented research was based on a retrospective analysis including 710 ambulatory and hospitalized patients treated with CBZ between the years 1991 and 2011. The method used for the determination of the CBZ concentration was fluorescence polarization immunoassay (FPIA) performed using an Abbott GmbH TDx automatic analyzer, with the therapeutic range for carbamazepine being 4-12 µg/mL.
The therapeutic range was observed more often in patients between 3 and 17 years of age compared with the population ≥18 years of age (73.5% vs. 68.8%). The therapeutic level was exceeded less frequently in the population between 3 and 17 years of age despite them being given a significantly higher dose per kilogram of body weight than in the population ≥18 years of age (13.64 mg/kg vs. 10.43 mg/kg, < 0.0001). Patients ≥18 years of age were statistically significantly more likely to be in the group with a suspected drug overdose (73.9% vs. 26.1%), and suicide attempts only occurred in elderly patients (100.0% vs. 0.0%, = 0.003).
The results of the TDM of CBZ showed that only 71% of all samples were at the therapeutic level. To ensure the maximum efficacy and safety of the therapy, it is necessary to monitor the concentration of CBZ regardless of sex and age.
卡马西平（CBZ）是第一代抗惊厥药物。因此，在某些情况下，治疗药物监测（TDM）有助于药物治疗。
本研究基于一项回顾性分析，纳入了1991年至2011年间710例接受CBZ治疗的门诊和住院患者。使用雅培公司的TDx自动分析仪通过荧光偏振免疫分析法（FPIA）测定CBZ浓度，卡马西平的治疗范围为4-12μg/mL。
与≥18岁的人群相比，3至17岁的患者更常处于治疗范围内（73.5%对68.8%）。尽管3至17岁人群每公斤体重的给药剂量明显高于≥18岁人群（13.64mg/kg对10.43mg/kg，P<0.0001），但该年龄段人群超过治疗水平的情况较少。≥18岁的患者在疑似药物过量组中的比例在统计学上显著更高（73.9%对26.1%），且自杀未遂仅发生在老年患者中（100.0%对0.0%，P=0.003）。
CBZ的TDM结果显示，所有样本中只有71%处于治疗水平。为确保治疗的最大疗效和安全性，无论性别和年龄，都有必要监测CBZ的浓度。
