Daily Clinical Dose (D) poorly predicts trough serum methadone concentration (C trough) in patients undergo methadone maintenance therapy with good adherence

Methadone maintenance therapy (MMT) has been used for opioid dependence as one of the harm-reduction approaches. It is also effective indirectly to prevent the wide spread of HIV-related risks such as needle sharing behaviour and illicit drug use. With low costs calculated per patient, MMT has been...

Full description

Bibliographic Details
Main Authors: Mohamed Nazar, Nor Ilyani, Sim , Hann Liang, Tan, Soo Choon, Ismail, Rusli, Musa, Ramli, Abu Bakar, Ahmad Zafri
Format: Article
Language:English
Published: R. S. Publication 2014
Subjects:
Online Access:http://irep.iium.edu.my/36708/1/article_1.pdf
_version_ 1796878782467932160
author Mohamed Nazar, Nor Ilyani
Sim , Hann Liang
Tan, Soo Choon
Ismail, Rusli
Musa, Ramli
Abu Bakar, Ahmad Zafri
author_facet Mohamed Nazar, Nor Ilyani
Sim , Hann Liang
Tan, Soo Choon
Ismail, Rusli
Musa, Ramli
Abu Bakar, Ahmad Zafri
author_sort Mohamed Nazar, Nor Ilyani
collection IIUM
description Methadone maintenance therapy (MMT) has been used for opioid dependence as one of the harm-reduction approaches. It is also effective indirectly to prevent the wide spread of HIV-related risks such as needle sharing behaviour and illicit drug use. With low costs calculated per patient, MMT has been put as top priorities on reducing opioid dependencies in Malaysia. However, the effective dose strategy of the therapy is still open to debate. The study aimed to investigate the potential of methadone trough concentration (Ctrough) to be a surrogate marker for such purpose. We conducted a 9-months prospective study to assess the relationship between Ctrough and Dose (D) of methadone. A total of 115 subjects fulfilled the inclusion criteria and had given their consents to participate. Two (2) ml of the trough blood samples (Ctrough) were taken and centrifuged within 4 hours from the time taken at 5,000 G for 5 minutes. The resulting serum samples were kept at -20°C until further analysis. The methadone concentration was determined by using a validated method for Methadone ELISA kit. The patients were subjected to another 2 follow ups at 3 months interval each and the same method of serum sampling was applied. Initial correlation reveals significant positive correlation between the two variables in every follow up, ranging between r=0.403-0.419 (p<0.005). Further regression analysis reveals that the coefficient of determination, r2 was poor with only 15-17% of variation in the Ctrough can be explained by the changes in clinical doses (p<0.005). Based on the results, we conclude that daily clinical dose poorly predicts methadone Ctrough for the purpose of dosing adjustment and monitoring of therapy.
first_indexed 2024-03-05T23:26:24Z
format Article
id oai:generic.eprints.org:36708
institution International Islamic University Malaysia
language English
last_indexed 2024-03-05T23:26:24Z
publishDate 2014
publisher R. S. Publication
record_format dspace
spelling oai:generic.eprints.org:367082014-05-23T02:50:09Z http://irep.iium.edu.my/36708/ Daily Clinical Dose (D) poorly predicts trough serum methadone concentration (C trough) in patients undergo methadone maintenance therapy with good adherence Mohamed Nazar, Nor Ilyani Sim , Hann Liang Tan, Soo Choon Ismail, Rusli Musa, Ramli Abu Bakar, Ahmad Zafri RM300 Drugs and their action Methadone maintenance therapy (MMT) has been used for opioid dependence as one of the harm-reduction approaches. It is also effective indirectly to prevent the wide spread of HIV-related risks such as needle sharing behaviour and illicit drug use. With low costs calculated per patient, MMT has been put as top priorities on reducing opioid dependencies in Malaysia. However, the effective dose strategy of the therapy is still open to debate. The study aimed to investigate the potential of methadone trough concentration (Ctrough) to be a surrogate marker for such purpose. We conducted a 9-months prospective study to assess the relationship between Ctrough and Dose (D) of methadone. A total of 115 subjects fulfilled the inclusion criteria and had given their consents to participate. Two (2) ml of the trough blood samples (Ctrough) were taken and centrifuged within 4 hours from the time taken at 5,000 G for 5 minutes. The resulting serum samples were kept at -20°C until further analysis. The methadone concentration was determined by using a validated method for Methadone ELISA kit. The patients were subjected to another 2 follow ups at 3 months interval each and the same method of serum sampling was applied. Initial correlation reveals significant positive correlation between the two variables in every follow up, ranging between r=0.403-0.419 (p<0.005). Further regression analysis reveals that the coefficient of determination, r2 was poor with only 15-17% of variation in the Ctrough can be explained by the changes in clinical doses (p<0.005). Based on the results, we conclude that daily clinical dose poorly predicts methadone Ctrough for the purpose of dosing adjustment and monitoring of therapy. R. S. Publication 2014 Article PeerReviewed application/pdf en http://irep.iium.edu.my/36708/1/article_1.pdf Mohamed Nazar, Nor Ilyani and Sim , Hann Liang and Tan, Soo Choon and Ismail, Rusli and Musa, Ramli and Abu Bakar, Ahmad Zafri (2014) Daily Clinical Dose (D) poorly predicts trough serum methadone concentration (C trough) in patients undergo methadone maintenance therapy with good adherence. International Journal of Pharmaceutical Science and Health Care, 2 (4). pp. 1-9. ISSN 2249-5738 http://rspublication.com/ijphc/2014/april14/23.pdf
spellingShingle RM300 Drugs and their action
Mohamed Nazar, Nor Ilyani
Sim , Hann Liang
Tan, Soo Choon
Ismail, Rusli
Musa, Ramli
Abu Bakar, Ahmad Zafri
Daily Clinical Dose (D) poorly predicts trough serum methadone concentration (C trough) in patients undergo methadone maintenance therapy with good adherence
title Daily Clinical Dose (D) poorly predicts trough serum methadone concentration (C trough) in patients undergo methadone maintenance therapy with good adherence
title_full Daily Clinical Dose (D) poorly predicts trough serum methadone concentration (C trough) in patients undergo methadone maintenance therapy with good adherence
title_fullStr Daily Clinical Dose (D) poorly predicts trough serum methadone concentration (C trough) in patients undergo methadone maintenance therapy with good adherence
title_full_unstemmed Daily Clinical Dose (D) poorly predicts trough serum methadone concentration (C trough) in patients undergo methadone maintenance therapy with good adherence
title_short Daily Clinical Dose (D) poorly predicts trough serum methadone concentration (C trough) in patients undergo methadone maintenance therapy with good adherence
title_sort daily clinical dose d poorly predicts trough serum methadone concentration c trough in patients undergo methadone maintenance therapy with good adherence
topic RM300 Drugs and their action
url http://irep.iium.edu.my/36708/1/article_1.pdf
work_keys_str_mv AT mohamednazarnorilyani dailyclinicaldosedpoorlypredictstroughserummethadoneconcentrationctroughinpatientsundergomethadonemaintenancetherapywithgoodadherence
AT simhannliang dailyclinicaldosedpoorlypredictstroughserummethadoneconcentrationctroughinpatientsundergomethadonemaintenancetherapywithgoodadherence
AT tansoochoon dailyclinicaldosedpoorlypredictstroughserummethadoneconcentrationctroughinpatientsundergomethadonemaintenancetherapywithgoodadherence
AT ismailrusli dailyclinicaldosedpoorlypredictstroughserummethadoneconcentrationctroughinpatientsundergomethadonemaintenancetherapywithgoodadherence
AT musaramli dailyclinicaldosedpoorlypredictstroughserummethadoneconcentrationctroughinpatientsundergomethadonemaintenancetherapywithgoodadherence
AT abubakarahmadzafri dailyclinicaldosedpoorlypredictstroughserummethadoneconcentrationctroughinpatientsundergomethadonemaintenancetherapywithgoodadherence