antiepileptics: new research from labor krone supports microsampling for lamotrigin, levetiracetam, and lacosamid
For therapeutic drug monitoring, researchers and clinicians have long sought workable alternatives to venous blood collection, which is expensive as well as uncomfortable and inconvenient for all involved. Currently, dried blood microsampling is gaining wider acclaim and use, as it is simpler and easier and helps eliminate shipping and storage costs along with unnecessary time spent in clinics and waiting rooms for patients.
In cooperation with Mara-Hospital in Beilefeld-Bethel, Dr. Dennis Klimpel of MVZ Labor Krone has recently conducted research on the suitability of dried blood samples in therapeutic drug monitoring for antiepileptics, particularly for the drugs Lamotrigin, Levetiracetam, and Lacosamid, frequently prescribed and monitored in cases of epilepsy therapy. Dr. Klimpel presented his results in a speech at the 54. Jahrestagung der Deutschen Gesellschaft für Epileptologie (DGfE) in Fürth, Germany on the 16th of June 2018.
Encouragingly, Dr. Klimpel’s results suggest that Volumetric Absorptive Microsampling (VAMS™) techniques using Mitra® devices from Neoteryx does indeed present a novel, economical, and smarter alternative to wet samples collected through venipuncture as well as the dried blood spot (DBS) cards and filter paper commonly used in the past to collect small-volume dried blood samples.
Dr. Klimpel’s team observed strong correlations in concentration levels of the drugs in question observed in capillary blood samples compared to those in serum. Furthermore, Mitra microsampling collection was associated with more exact (and therefore more potentially useful) measurements than DBS filter-paper techniques.
“These observations also reflect on our practical experience in handling these two dried blood sampling techniques,” said Dr. Klimpel. “Using DBS filter-paper technique, a glass capillary is necessary for volumetric sampling. Inaccurate handling can easily lead to air bubbles in the capillary, which precludes the collection of accurate amounts of blood. With Mitra microsamplers, these difficulties with volumetric sampling did not occur.”
Dr. Klimpel’s findings echo other recent findings in the realm of therapeutic drug monitoring for antiepileptics. All in all, microsampling clearly provides a strong alternative to older TDM blood collection techniques and that the increased interest in VAMS techniques using Mitra microsampling devices for this purpose is relevant, justified, and likely to continue and grow.
Topics: Patient Monitoring