Non-invasive therapeutic drug monitoring: LC-MS validation for lamotrigine quantification in dried blood spot and oral fluid/saliva
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články, validační studie
PubMed
40239559
DOI
10.1016/j.jpba.2025.116877
PII: S0731-7085(25)00218-3
Knihovny.cz E-zdroje
- Klíčová slova
- Alternative matrix, Antiepileptics, Dried blood spot, Lamotrigine, Quantification, Saliva, Validation,
- MeSH
- antikonvulziva * analýza krev MeSH
- chromatografie kapalinová metody MeSH
- epilepsie farmakoterapie MeSH
- kalibrace MeSH
- kapalinová chromatografie-hmotnostní spektrometrie MeSH
- lamotrigin * analýza krev MeSH
- lidé MeSH
- limita detekce MeSH
- monitorování léčiv * metody MeSH
- reprodukovatelnost výsledků MeSH
- sliny * chemie MeSH
- tandemová hmotnostní spektrometrie metody MeSH
- test suché kapky krve * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- validační studie MeSH
- Názvy látek
- antikonvulziva * MeSH
- lamotrigin * MeSH
Epilepsy, affecting over 50 million people globally, presents a significant neurological challenge. Effective prevention of epileptic seizures relies on proper administration and monitoring of Anti-Seizure Medication (ASMs). Therapeutic Drug Monitoring (TDM) ensures optimal dosage adjustment, minimizing adverse effects and potential drug interactions. While traditional venous blood collection for TDM may be stressful, emerging alternative sampling methods, particularly Dried Blood Spot (DBS) or oral fluid offer less invasive way of sampling. This study aimed to develop and validate an analytical method for the determination of lamotrigine in such alternative samples. The sample, either DBS or oral fluid, was subjected to extraction, evaporation, and reconstitution in 15 % acetonitrile containing 0.1 % formic acid. A Kinetex C18 Polar column was used for liquid chromatographic separation and MS in ESI+ mode was used for detection and quantitation of lamotrigine using an isotopically labelled internal standard according to EMA guidelines. The calibration range of the developed method enables the determination of lamotrigine in the concentration range of 1-30 μg/mL in DBS and 0.5-20 μg/mL in oral fluid. Oral fluid and DBS samples from patients treated with lamotrigine analysed by the developed method were compared to plasma concentrations measured by the hospital's accredited laboratory. Preliminary results indicate a promising potential for these alternative matrices in clinical TDM applications. By offering a less invasive sampling approach, this method improves the accessibility and safety of pharmacotherapy for epilepsy patients. The results of this study lay the foundation for further clinical applications by implementing alternative matrix TDM, which may significantly advance personalized care in epilepsy management.
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