Measurement of Dabigatran Concentration Using Finger Prick Dried Blood Spot Sample Collection
Background and Purpose: Real-world laboratory monitoring of dabigatran activity is challenging. The purpose of the present study was to demonstrate the feasibility and accuracy of finger prick sampling with dried blood spot (fpDBS) cards in measuring the dabigatran concentration.Material and Methods...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-05-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2021.679431/full |
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| author | Shin-Yi Lin Shin-Yi Lin Yu-Fong Peng Chih-Fen Huang Chih-Fen Huang Ching-Hua Kuo Sung-Chun Tang Jiann-Shing Jeng |
| author_facet | Shin-Yi Lin Shin-Yi Lin Yu-Fong Peng Chih-Fen Huang Chih-Fen Huang Ching-Hua Kuo Sung-Chun Tang Jiann-Shing Jeng |
| author_sort | Shin-Yi Lin |
| collection | DOAJ |
| description | Background and Purpose: Real-world laboratory monitoring of dabigatran activity is challenging. The purpose of the present study was to demonstrate the feasibility and accuracy of finger prick sampling with dried blood spot (fpDBS) cards in measuring the dabigatran concentration.Material and Methods: Patients >20 years of age with atrial fibrillation and receiving dabigatran therapy for more than 7 days were included in the study. Peak and trough dabigatran concentrations were collected by simultaneous finger prick and venous puncture. The dabigatran concentration was measured by ultra-high performance liquid chromatography with tandem mass spectrometry. Our previously developed post-column infused internal standard (PCI-IS) method was applied to estimate the blood spot volume on fpDBS and to calibrate the drug concentration. Deming regression was used to analyze the correlation between dabigatran concentration on fpDBS cards and in plasma samples, followed by Bland–Altman analysis to compare the bias between two sampling techniques.Results: A total of 33 patients were enrolled and contributed 66 plasma and 55 fpDBS dabigatran samples. The average patient age was 74.6 ± 7.9 years, mean creatinine clearance 58.1 ± 18.3 mL/min, and CHA2DS2-VASc score 3.5 ± 1.6 points. The dabigatran concentration ranged from 41.8–1421.7 ng/mL. The plasma and DBS dabigatran concentrations correlated well (r = 0.98), and the conversion factor for fpDBS to plasma dabigatran concentration was 1.28. The Bland–Altman analysis showed that 94.5% of the fpDBS-predicted concentration fell within 20% of bias.Conclusions: The study showed that fpDBS measurement of dabigatran concentration is reliable and can be applied in clinical scenarios. |
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| format | Article |
| id | doaj.art-d964d719308e4f75996b036743000f1c |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-21T22:29:26Z |
| publishDate | 2021-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-d964d719308e4f75996b036743000f1c2022-12-21T18:48:08ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-05-011210.3389/fphar.2021.679431679431Measurement of Dabigatran Concentration Using Finger Prick Dried Blood Spot Sample CollectionShin-Yi Lin0Shin-Yi Lin1Yu-Fong Peng2Chih-Fen Huang3Chih-Fen Huang4Ching-Hua Kuo5Sung-Chun Tang6Jiann-Shing Jeng7Department of Pharmacy, National Taiwan University Hospital, Taipei, TaiwanSchool of Pharmacy, College of Medicine, National Taiwan University, Taipei, TaiwanSchool of Pharmacy, College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Pharmacy, National Taiwan University Hospital, Taipei, TaiwanSchool of Pharmacy, College of Medicine, National Taiwan University, Taipei, TaiwanSchool of Pharmacy, College of Medicine, National Taiwan University, Taipei, TaiwanStroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, TaiwanStroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, TaiwanBackground and Purpose: Real-world laboratory monitoring of dabigatran activity is challenging. The purpose of the present study was to demonstrate the feasibility and accuracy of finger prick sampling with dried blood spot (fpDBS) cards in measuring the dabigatran concentration.Material and Methods: Patients >20 years of age with atrial fibrillation and receiving dabigatran therapy for more than 7 days were included in the study. Peak and trough dabigatran concentrations were collected by simultaneous finger prick and venous puncture. The dabigatran concentration was measured by ultra-high performance liquid chromatography with tandem mass spectrometry. Our previously developed post-column infused internal standard (PCI-IS) method was applied to estimate the blood spot volume on fpDBS and to calibrate the drug concentration. Deming regression was used to analyze the correlation between dabigatran concentration on fpDBS cards and in plasma samples, followed by Bland–Altman analysis to compare the bias between two sampling techniques.Results: A total of 33 patients were enrolled and contributed 66 plasma and 55 fpDBS dabigatran samples. The average patient age was 74.6 ± 7.9 years, mean creatinine clearance 58.1 ± 18.3 mL/min, and CHA2DS2-VASc score 3.5 ± 1.6 points. The dabigatran concentration ranged from 41.8–1421.7 ng/mL. The plasma and DBS dabigatran concentrations correlated well (r = 0.98), and the conversion factor for fpDBS to plasma dabigatran concentration was 1.28. The Bland–Altman analysis showed that 94.5% of the fpDBS-predicted concentration fell within 20% of bias.Conclusions: The study showed that fpDBS measurement of dabigatran concentration is reliable and can be applied in clinical scenarios.https://www.frontiersin.org/articles/10.3389/fphar.2021.679431/fulldabigatranfinger prick testtherapeutic drug monitoringnon-vitamin K antagonist oral anticoagulantsdrug concentration |
| spellingShingle | Shin-Yi Lin Shin-Yi Lin Yu-Fong Peng Chih-Fen Huang Chih-Fen Huang Ching-Hua Kuo Sung-Chun Tang Jiann-Shing Jeng Measurement of Dabigatran Concentration Using Finger Prick Dried Blood Spot Sample Collection Frontiers in Pharmacology dabigatran finger prick test therapeutic drug monitoring non-vitamin K antagonist oral anticoagulants drug concentration |
| title | Measurement of Dabigatran Concentration Using Finger Prick Dried Blood Spot Sample Collection |
| title_full | Measurement of Dabigatran Concentration Using Finger Prick Dried Blood Spot Sample Collection |
| title_fullStr | Measurement of Dabigatran Concentration Using Finger Prick Dried Blood Spot Sample Collection |
| title_full_unstemmed | Measurement of Dabigatran Concentration Using Finger Prick Dried Blood Spot Sample Collection |
| title_short | Measurement of Dabigatran Concentration Using Finger Prick Dried Blood Spot Sample Collection |
| title_sort | measurement of dabigatran concentration using finger prick dried blood spot sample collection |
| topic | dabigatran finger prick test therapeutic drug monitoring non-vitamin K antagonist oral anticoagulants drug concentration |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2021.679431/full |
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