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Salvator H, Lamy E, Roquencourt C, Bardin E, Devillier P, Grassin-Delyle S. Therapeutic drug monitoring of corticosteroids/β 2-agonists in the hair of patients with asthma: an open-label feasibility study. Front Pharmacol 2024; 14:1339835. [PMID: 38269282 PMCID: PMC10807032 DOI: 10.3389/fphar.2023.1339835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Background: Although adherence to inhaled medication is critically important for treatment efficiency, around half of patients taking these drugs are non-adherent or make critical errors when using their delivery device. Segmental hair analysis might be a valuable tool for therapeutic monitoring because hair concentrations reflect exposure from month to month. The objective of the present proof-of-concept study was to establish the feasibility of segmental hair analysis of inhaled budesonide and formoterol in asthma patients. Methods: We conducted a prospective, open-label, interventional study of adult patients being treated with budesonide/formoterol for controlled, moderate-to-severe asthma (CorticHair, NCT03691961). Asthma control, lung function, and medication adherence were recorded. Hair samples were taken 4 months after enrolment and cut into four 1 cm segments. Results: Samples were available from 21 patients (20 women; median age: 53; median budesonide dose: 600 μg/d). Budesonide and formoterol were detected in samples from 18 to 13 patients, respectively. The median hair concentrations were 6.25 pg/mg for budesonide and 0.9 pg/mg for formoterol. The intrapatient coefficient of variation between hair segments was 21% for budesonide and 40% for formoterol. Pearson's coefficients for the correlations between the hair concentration and the self-reported drug dose and the prescribed drug dose were respectively 0.42 (p = 0.08) and 0.29 (p = 0.25) for budesonide and 0.24 (p = 0.44) and 0.17 (p = 0.57) for formoterol. Conclusion: Segmental hair analysis of inhaled medications was feasible, with low intrapatient variability. This innovative, non-invasive means of assessing monthly drug exposure might help physicians to personalize drug regimens for patients with difficult-to-treat asthma.
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Affiliation(s)
- Hélène Salvator
- Exhalomics, Hôpital Foch, Suresnes, France
- Service de Pneumologie, Hôpital Foch, Suresnes, France
- Laboratoire de Recherche en Pharmacologie Respiratoire—VIM Suresnes, UMR 0892, Université Paris-Saclay, Suresnes, France
| | - Elodie Lamy
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de La Santé, Montigny-le-Bretonneux, France
| | | | - Emmanuelle Bardin
- Exhalomics, Hôpital Foch, Suresnes, France
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de La Santé, Montigny-le-Bretonneux, France
- Institut Necker Enfants Malades, U1151, Paris, France
| | - Philippe Devillier
- Exhalomics, Hôpital Foch, Suresnes, France
- Laboratoire de Recherche en Pharmacologie Respiratoire—VIM Suresnes, UMR 0892, Université Paris-Saclay, Suresnes, France
| | - Stanislas Grassin-Delyle
- Exhalomics, Hôpital Foch, Suresnes, France
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de La Santé, Montigny-le-Bretonneux, France
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Zijp TR, Izzah Z, Åberg C, Gan CT, Bakker SJL, Touw DJ, van Boven JFM. Clinical Value of Emerging Bioanalytical Methods for Drug Measurements: A Scoping Review of Their Applicability for Medication Adherence and Therapeutic Drug Monitoring. Drugs 2021; 81:1983-2002. [PMID: 34724175 PMCID: PMC8559140 DOI: 10.1007/s40265-021-01618-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2021] [Indexed: 12/05/2022]
Abstract
INTRODUCTION Direct quantification of drug concentrations allows for medication adherence monitoring (MAM) and therapeutic drug monitoring (TDM). Multiple less invasive methods have been developed in recent years: dried blood spots (DBS), saliva, and hair analyses. AIM To provide an overview of emerging drug quantification methods for MAM and TDM, focusing on the clinical validation of methods in patients prescribed chronic drug therapies. METHODS A scoping review was performed using a systematic search in three electronic databases covering the period 2000-2020. Screening and inclusion were performed by two independent reviewers in Rayyan. Data from the articles were aggregated in a REDCap database. The main outcome was clinical validity of methods based on study sample size, means of cross-validation, and method description. Outcomes were reported by matrix, therapeutic area and application (MAM and/or TDM). RESULTS A total of 4590 studies were identified and 175 articles were finally included; 57 on DBS, 66 on saliva and 55 on hair analyses. Most reports were in the fields of neurological diseases (37%), infectious diseases (31%), and transplantation (14%). An overview of clinical validation was generated of all measured drugs. A total of 62 drugs assays were applied for MAM and 131 for TDM. CONCLUSION MAM and TDM are increasingly possible without traditional invasive blood sampling: the strengths and limitations of DBS, saliva, and hair differ, but all have potential for valid and more convenient drug monitoring. To strengthen the quality and comparability of future evidence, standardisation of the clinical validation of the methods is recommended.
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Affiliation(s)
- Tanja R Zijp
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands
| | - Zamrotul Izzah
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
- University of Groningen, Groningen Research Institute of Pharmacy, Department of Pharmaceutical Analysis, Groningen, The Netherlands
| | - Christoffer Åberg
- University of Groningen, Groningen Research Institute of Pharmacy, Department of Pharmaceutical Analysis, Groningen, The Netherlands
| | - C Tji Gan
- University of Groningen, University Medical Center Groningen, Respiratory Diseases and Lung Transplantation, Groningen, The Netherlands
| | - Stephan J L Bakker
- University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Division of Nephrology, Groningen, The Netherlands
| | - Daan J Touw
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands.
- University of Groningen, Groningen Research Institute of Pharmacy, Department of Pharmaceutical Analysis, Groningen, The Netherlands.
- Medication Adherence Expertise Center of the Northern Netherlands (MAECON), Groningen, The Netherlands.
| | - Job F M van Boven
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands
- Medication Adherence Expertise Center of the Northern Netherlands (MAECON), Groningen, The Netherlands
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Wang X, Zhuo Y, Tang X, Qiang H, Liu W, Wu H, Xiang P, Duan G, Shen M. Segmental analysis of antidepressant and antipsychotic drugs in the hair of schizophrenic patients. Drug Test Anal 2020; 12:472-484. [DOI: 10.1002/dta.2754] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/09/2019] [Accepted: 12/19/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Xin Wang
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic MedicineShanghai Forensic Service Platform, Academy of Forensic Science Shanghai China
| | - Yue Zhuo
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic MedicineShanghai Forensic Service Platform, Academy of Forensic Science Shanghai China
- Institute of Forensic ScienceGuizhou Medical University Guiyang China
| | - Xiaowei Tang
- Affiliated WuTaiShan Hospital of Medical College of Yangzhou University Yangzhou Jiangsu China
| | - Huosheng Qiang
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic MedicineShanghai Forensic Service Platform, Academy of Forensic Science Shanghai China
| | - Wei Liu
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic MedicineShanghai Forensic Service Platform, Academy of Forensic Science Shanghai China
| | - Hejian Wu
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic MedicineShanghai Forensic Service Platform, Academy of Forensic Science Shanghai China
| | - Ping Xiang
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic MedicineShanghai Forensic Service Platform, Academy of Forensic Science Shanghai China
| | - Gengli Duan
- Department of Pharmaceutical Analysis, School of PharmacyFudan University Shanghai China
| | - Min Shen
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic MedicineShanghai Forensic Service Platform, Academy of Forensic Science Shanghai China
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Methling M, Krumbiegel F, Hartwig S. Hair analysis of antidepressants and antipsychotics—Overview of quantitative data. Drug Test Anal 2020; 12:659-676. [DOI: 10.1002/dta.2784] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/18/2020] [Accepted: 02/21/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Maximilian Methling
- Institute of Legal Medicine and Forensic SciencesCharité‐University Medicine Berlin Berlin Germany
- Institute of Pharmacy, Pharmaceutical ChemistryFreie Universität Berlin Berlin Germany
| | - Franziska Krumbiegel
- Institute of Legal Medicine and Forensic SciencesCharité‐University Medicine Berlin Berlin Germany
| | - Sven Hartwig
- Institute of Legal Medicine and Forensic SciencesCharité‐University Medicine Berlin Berlin Germany
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Zhang C, Peng D, Lv L, Zhuo K, Yu K, Shen T, Xu Y, Wang Z. Individual Perceived Stress Mediates Psychological Distress in Medical Workers During COVID-19 Epidemic Outbreak in Wuhan. Neuropsychiatr Dis Treat 2020; 16:2529-2537. [PMID: 33149594 PMCID: PMC7604251 DOI: 10.2147/ndt.s266151] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/12/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Since the novel coronavirus disease (COVID-19) outbreak in Wuhan, thousands of medical workers have been dispatched to support Wuhan against the virus. The purpose of this study was to identify the independent risk factors for psychological distress in order to develop a more effective strategy and precise evidence-based psychological intervention for medical workers. METHODS This multisite cross-sectional survey recruited doctors and nurses from local and nonlocal medical teams working at 16 hospitals in Wuhan to complete this online survey from February to March, 2020. Psychological status was evaluated through Perceived Stress Scales (PSS), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder Scale (GAD-7) and Acute Stress Disorder Scale (ASDS). RESULTS Of 966 participants, the prevalence of stress (95.9%), depression (46.0%) and anxiety (39.3%) were high. Local medical workers exhibited even higher scores of PSS, PHQ-9, GAD-7 and ASDS than those from outside Hubei (P<0.001). Females had more severe perceived stress, depression and anxiety than males (P<0.001). Multiple logistic regression showed that perceived stress is associated with increased odds of depression (OR=1.413; 95% CI: 1.338-1.493; P<0.001) and anxiety (OR=1.515; 95% CI: 1.407-1.631; P<0.001). CONCLUSION Our findings demonstrated a high prevalence of stress, depression, anxiety and acute distress among medical workers on the front-line during the COVID-19 outbreak in Wuhan. The level of psychological impact may be mediated by individual perceptions of stressful events.
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Affiliation(s)
- Chen Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Shanghai Psychological Medical Team Supporting Hubei, Shanghai, People's Republic of China
| | - Daihui Peng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Shanghai Psychological Medical Team Supporting Hubei, Shanghai, People's Republic of China
| | - Lu Lv
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Kaiming Zhuo
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Shanghai Psychological Medical Team Supporting Hubei, Shanghai, People's Republic of China
| | - Kai Yu
- MoE Key Laboratory of Artificial Intelligence, AI Institute Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Tian Shen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yifeng Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Shanghai Psychological Medical Team Supporting Hubei, Shanghai, People's Republic of China
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