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Schierscher T, Salzmann L, Singh N, Wild J, Fischer V, Bauland F, Geistanger A, Risch L, Geletneky C, Seger C, Taibon J. An isotope dilution-liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS)-based candidate reference measurement procedure for the quantification of zonisamide in human serum and plasma. Clin Chem Lab Med 2024; 62:1288-1300. [PMID: 38105272 DOI: 10.1515/cclm-2023-0736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/03/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES To describe and validate an isotope dilution-liquid chromatograph-tandem mass spectrometry (ID-LC-MS/MS) based reference measurement procedure (RMP) for zonisamide to accurately measure serum and plasma concentrations. METHODS Quantitative nuclear magnetic resonance (qNMR) spectroscopy was employed to determine the absolute content of the reference material used in order to establish traceability to SI units. Separation of zonisamide from known or unknown interferences was performed on a C8 column. For sample preparation a protocol based on protein precipitation in combination with a high dilution step was established. Assay validation and determination of measurement uncertainty were performed based on guidelines from the Clinical and Laboratory Standards Institute, the International Conference on Harmonization, and the Guide to the expression of uncertainty in measurement. RESULTS The RMP was proven to be highly selective and specific with no evidence of a matrix effect, allowing for quantification of zonisamide within the range of 1.50-60.0 μg/mL. Intermediate precision was <1.4 % and repeatability CV ranged from 0.7 to 1.2 % over all concentration levels. The relative mean bias ranged from 0.0 to 0.8 % for native serum levels and from 0.2 to 2.0 % for Li-heparin plasma levels. The measurement uncertainties for single measurements and target value assignment ranged from 1.1 to 1.4 % and 0.8-1.0 %, respectively. CONCLUSIONS We present a novel LC-MS/MS-based candidate RMP for zonisamide in human serum and plasma which provides a traceable and reliable platform for the standardization of routine assays and evaluation of clinically relevant samples.
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Affiliation(s)
| | | | | | - Janik Wild
- Dr. Risch Ostschweiz AG, Buchs, Switzerland
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Pokorná P, Šíma M, Švestková N, Slanař O. Levetiracetam pharmacokinetics and its covariates: proposal for optimal dosing in the paediatric population. Eur J Hosp Pharm 2023; 30:359-362. [PMID: 34753796 PMCID: PMC10647855 DOI: 10.1136/ejhpharm-2021-003062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/26/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Levetiracetam is an anticonvulsive drug increasingly used in paediatric populations. Ontogenesis may alter its pharmacokinetics, demanding dose individualisation of levetiracetam in paediatric populations. We therefore aimed to explore levetiracetam pharmacokinetics and to propose its optimal dosing in the paediatric population. METHODS Individual levetiracetam pharmacokinetic parameters were calculated based on therapeutic drug monitoring data, using a one-compartmental model, and regression models were used to explore possible covariates. RESULTS 56 patients aged from 47 days to 18 years were included in the analysis. The median (IQR) volume of distribution and clearance of levetiracetam were 0.7 (0.58-0.85) L/kg and 0.123 (0.085-0.167) L/hour/kg, respectively. Levetiracetam pharmacokinetics were influenced by postnatal age, body size descriptors and renal functional status. CONCLUSIONS Based on observed relationships, an individualised loading dose of 26.2 mg/kg body weight and maintenance dose of 20.7 mg/mL/min of estimated glomerular filtration rate were calculated as optimal. Since we observed increased levetiracetam clearance in association with valproate co-medication, caution should be used when combining these two drugs.
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Affiliation(s)
- Pavla Pokorná
- Department of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
- Department of Physiology and Pharmacology, Karolinska University Hospital, Stockholm, Sweden
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
- Intensive Care and Department of Pediatric Surgery, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Martin Šíma
- Department of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Natálie Švestková
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Ondřej Slanař
- Department of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Yang Q, Hu Y, Zhang X, Zhang X, Dai H, Li X. Population pharmacokinetics of oxcarbazepine 10-monohydroxy derivative in Chinese adult epileptic patients. Eur J Hosp Pharm 2023; 30:e90-e96. [PMID: 35787526 PMCID: PMC10086726 DOI: 10.1136/ejhpharm-2022-003357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/14/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Oxcarbazepine (OXC) is metabolised to active 10-monohydroxy derivative (MHD) after oral administration. Using this fact we aimed to develop an MHD population pharmacokinetic (PPK) model in Chinese adult epileptic patients to facilitate the clinical implementation of model-guided individualised drug therapy. METHODS We collected blood samples from Chinese adult epileptic patients taking OXC at the Second Affiliated Hospital of Zhejiang University School of Medicine. We used high performance liquid chromatography (HPLC-MS/MS) with tandem mass spectrometry to detect MHD concentrations in the blood samples. We collected various data from patients including their demographic, pathological, and physiological information. MassARRAY method was used to detect ABCC2, ABCB1, SCN8A, SCN1A, SCN2A, SCN3A, UGT1A9, and UGT2B7 gene polymorphisms. We used a nonlinear mixed-effects modelling method to develop the PPK model and we predicted dosing regimens through simulation. RESULT In total we collected 164 blood samples from 118 patients. We found that a one-compartment model with first-order absorption better described the in vivo MHD pharmacokinetics. UGT2B7 gene (rs7439366) site mutation and the combined use of valproic acid enhanced the MHD clearance rate. We divided patients into groups based on the UGT2B7 genotype and whether they were also using valproic acid at the same time. Individualised OXC dosing regimens were proposed for different subgroups of patients. CONCLUSION In Chinese adult epileptic patients, individualised drug administration can be facilitated using a PPK model of OXC. TRIAL REGISTRATION NUMBER ChiCTR-OOC-17012141.
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Affiliation(s)
- QiaoWei Yang
- Department of Pharmacy, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, China
- Department of Pharmacy, Sanmen People's Hospital, Taizhou, Zhejiang Province, People's Republic of China
| | - Yan Hu
- Department of Pharmacy, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, China
- Department of Pharmacy, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
| | - XuanLing Zhang
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
| | - XiaoMin Zhang
- Department of Pharmacy, Sanmen People's Hospital, Taizhou, Zhejiang Province, People's Republic of China
| | - Haibin Dai
- Department of Pharmacy, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, China
| | - Xingang Li
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
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Yao L, Ren L, Chen Q, Wu Y, Xu J, Xia Q, Zhang C, Chen W. Rapid and direct concentration range judgment of lamotrigine in plasma by the multi test lines with different detection limits on the same lateral flow strip. Anal Chim Acta 2021; 1192:339347. [DOI: 10.1016/j.aca.2021.339347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 11/01/2022]
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Shi M, Jiang Q, Lyu Q, Yuan Z, Deng L, Yin L. A LC-MS 3 strategy to determine lamotrigine by Q-Q-trap tandem mass spectrometry coupled with triple stage fragmentation to enhance sensitivity and selectivity. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2021; 13:4478-4484. [PMID: 34505603 DOI: 10.1039/d1ay01372f] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A high-performance liquid chromatography tandem mass spectrometry cubed (HPLC/MS3) method was developed and validated to quantify lamotrigine in human plasma with carbamazepine as an internal standard. The HPLC/MS/MS system is composed of a Shimadzu UFLC XR high-performance liquid chromatograph coupled with a hybrid linear ion trap triple quadrupole mass spectrometer. Following simple protein precipitation with methanol, the separation of lamotrigine and carbamazepine was performed on an Agilent Poroshell 120 SB-C18 column (4.6 × 50 mm, 2.7 μm) using gradient elution with 0.1% formic acid in water (solvent I) and 0.1% formic acid in methanol (solvent II) at a flow rate of 0.8 mL min-1. The total run time for each sample was 5 min. The method was validated for accuracy, precision, linearity, lower limit of quantification (LLOQ), selectivity, and other parameters. The LC/MS3 method was linear in the concentration range of 0.50-50.0 μg mL-1 (R2 ≥ 0.995). The LLOQ was 0.5 μg mL-1, requiring only 30 μL of human plasma. Intra- and inter-day accuracies were <6.17% and precisions were <11.4% at all concentrations. The absolute recoveries (%) and matrix effect (%) for lamotrigine in human plasma were between 83.8 and 90.7. The developed and validated LC-MS3 assay was successfully applied to monitor the lamotrigine levels in human plasma after the administration of lamotrigine.
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Affiliation(s)
- Meiyun Shi
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 124221, PR China.
| | - Qiuhong Jiang
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 124221, PR China.
| | - Qiushi Lyu
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 124221, PR China.
| | - Zhengting Yuan
- School of Foreign Languages, Dalian University of Technology, Panjin, 124221, PR China
| | - Lili Deng
- Chongqing Health Statistics Information Center, Chongqing, 400021, PR China
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, Department of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, PR China
| | - Lei Yin
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, 124221, PR China.
- Department of Laboratory Medicine, The First Hospital of Jilin University, Jilin University, Xinmin Street, Changchun 130061, PR China
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Simultaneous quantification of oxcarbazepine and its active metabolite in spiked human plasma using ultra performance liquid chromatography-MS/MS. Bioanalysis 2021; 13:1259-1273. [PMID: 34463119 DOI: 10.4155/bio-2021-0125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: Clinical monitoring of oxcarbazepine (OXC) and its metabolite licarbazepine (MHD) in biological matrix requires a sensitive and validated analytical method. The aim of this study is to develop and validate an optimized ultra performance liquid chromatography-MS/MS based bioanalytical method for the simultaneous estimation of OXC and its metabolite MHD in human plasma, using deuterated internal standard method. Materials & methods: A reverse phase ultra performance liquid chromatography analysis and mass spectrometric detection was performed using electrospray ionization in positive ion mode as interface, multiple reaction monitoring as mode of acquisition. Results & conclusion: The linearity range was 10-4011 ng/ml for OXC and 40-16061 ng/ml for MHD. The kinetic parameters were calculated and compared for bioequivalence. This method fulfilled the validation guidelines, could be employed for determining bioavailability and in new formulation development studies.
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Simultaneous Quantification of 11 Antiseizure Medications and Metabolites in Serum for Therapeutic Drug Monitoring Using High-Performance Liquid Chromatography with Ultraviolet Detection. Ther Drug Monit 2021; 44:345-350. [DOI: 10.1097/ftd.0000000000000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/10/2021] [Indexed: 11/25/2022]
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Sommerfeld-Klatta K, Zielińska-Psuja B, Karaźniewcz-Łada M, Główka FK. New Methods Used in Pharmacokinetics and Therapeutic Monitoring of the First and Newer Generations of Antiepileptic Drugs (AEDs). Molecules 2020; 25:E5083. [PMID: 33147810 PMCID: PMC7663638 DOI: 10.3390/molecules25215083] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/23/2020] [Accepted: 10/28/2020] [Indexed: 12/30/2022] Open
Abstract
The review presents data from the last few years on bioanalytical methods used in therapeutic drug monitoring (TDM) of the 1st-3rd generation and the newest antiepileptic drug (AEDs) cenobamate in patients with various forms of seizures. Chemical classification, structure, mechanism of action, pharmacokinetic data and therapeutic ranges for total and free fractions and interactions were collected. The primary data on bioanalytical methods for AEDs determination included biological matrices, sample preparation, dried blood spot (DBS) analysis, column resolution, detection method, validation parameters, and clinical utility. In conclusion, the most frequently described method used in AED analysis is the LC-based technique (HPLC, UHPLC, USLC) combined with highly sensitive mass detection or fluorescence detection. However, less sensitive UV is also used. Capillary electrophoresis and gas chromatography have been rarely applied. Besides the precipitation of proteins or LLE, an automatic SPE is often a sample preparation method. Derivatization was also indicated to improve sensitivity and automate the analysis. The usefulness of the methods for TDM was also highlighted.
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Affiliation(s)
- Karina Sommerfeld-Klatta
- Department of Toxicology, Poznan University of Medical Sciences, 60-631 Poznań, Poland; (K.S.-K.); (B.Z.-P.)
| | - Barbara Zielińska-Psuja
- Department of Toxicology, Poznan University of Medical Sciences, 60-631 Poznań, Poland; (K.S.-K.); (B.Z.-P.)
| | - Marta Karaźniewcz-Łada
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 60-781 Poznań, Poland;
| | - Franciszek K. Główka
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 60-781 Poznań, Poland;
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Abstract
Given the distinctive characteristics of both epilepsy and antiepileptic drugs (AEDs), therapeutic drug monitoring (TDM) can make a significant contribution to the field of epilepsy. The measurement and interpretation of serum drug concentrations can be of benefit in the treatment of uncontrollable seizures and in cases of clinical toxicity; it can aid in the individualization of therapy and in adjusting for variable or nonlinear pharmacokinetics; and can be useful in special populations such as pregnancy. This review examines the potential for TDM of newer AEDs such as eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, perampanel, pregabalin, rufinamide, retigabine, stiripentol, tiagabine, topiramate, vigabatrin, and zonisamide. We describe the relationships between serum drug concentration, clinical effect, and adverse drug reactions for each AED as well as the different analytical methods used for serum drug quantification. We discuss retrospective studies and prospective data on the serum drug concentration-efficacy of these drugs and present the pharmacokinetic parameters, oral bioavailability, reference concentration range, and active metabolites of newer AEDs. Limited data are available for recent AEDs, and we discuss the connection between drug concentrations in terms of clinical efficacy and nonresponse. Although we do not propose routine TDM, serum drug measurement can play a beneficial role in patient management and treatment individualization. Standardized studies designed to assess, in particular, concentration-efficacy-toxicity relationships for recent AEDs are urgently required.
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Affiliation(s)
- Shery Jacob
- Department of Pharmaceutics, College of Pharmacy, Gulf Medical University, University Street, P.O.Box No.4184, Ajman, UAE.
| | - Anroop B Nair
- Department of Pharmaceutics, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
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Farouk F, ElKady EF, Azzazy HME. Simultaneous UPLC-MS/MS determination of antiepileptic agents for dose adjustment. Biomed Chromatogr 2017; 31. [DOI: 10.1002/bmc.3921] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/27/2016] [Accepted: 12/12/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Faten Farouk
- Pharmaceutical Chemistry Department, Faculty of Pharmacy; Ahram Canadian University; 6th of October City Egypt
| | - Ehab F. ElKady
- Pharmaceutical Chemistry Department, Faculty of Pharmacy; Cairo University; Cairo Egypt
| | - Hassan M. E. Azzazy
- Department of Chemistry, School of Science and Engineering; American University in Cairo; New Cairo Egypt
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A Parallel-Column LC–MS/MS Method for High-Throughput Analysis of Eight Antiepileptic Drugs in Clinical Therapeutic Drug Monitoring. Chromatographia 2016. [DOI: 10.1007/s10337-016-3196-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dupouey J, Doudka N, Belo S, Blin O, Guilhaumou R. Simultaneous determination of four antiepileptic drugs in human plasma samples using an ultra-high-performance liquid chromatography tandem mass spectrometry method and its application in therapeutic drug monitoring. Biomed Chromatogr 2016; 30:2053-2060. [DOI: 10.1002/bmc.3789] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/17/2016] [Accepted: 07/08/2016] [Indexed: 01/20/2023]
Affiliation(s)
- Julien Dupouey
- Service de Pharmacologie clinique et Pharmacovigilance; Hôpital de la Timone; 264 rue Saint Pierre 13385 Marseille Cedex 5 France
- Pharmacologie intégrée et Interface clinique et industriel, Institut des Neurosciences Timone - CNRS 7289; Aix Marseille Université; Marseille 13385 France
| | - Natalia Doudka
- Service de Pharmacologie clinique et Pharmacovigilance; Hôpital de la Timone; 264 rue Saint Pierre 13385 Marseille Cedex 5 France
| | - Séphora Belo
- Service de Pharmacologie clinique et Pharmacovigilance; Hôpital de la Timone; 264 rue Saint Pierre 13385 Marseille Cedex 5 France
| | - Olivier Blin
- Service de Pharmacologie clinique et Pharmacovigilance; Hôpital de la Timone; 264 rue Saint Pierre 13385 Marseille Cedex 5 France
- Pharmacologie intégrée et Interface clinique et industriel, Institut des Neurosciences Timone - CNRS 7289; Aix Marseille Université; Marseille 13385 France
| | - Romain Guilhaumou
- Service de Pharmacologie clinique et Pharmacovigilance; Hôpital de la Timone; 264 rue Saint Pierre 13385 Marseille Cedex 5 France
- Pharmacologie intégrée et Interface clinique et industriel, Institut des Neurosciences Timone - CNRS 7289; Aix Marseille Université; Marseille 13385 France
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