Abstract:
BACKGROUND:The International Interlaboratory Quality Control PROGRAM for Therapeutic Drug Monitoring of Antiretroviral Drugs in Human Plasma/Serum was initiated in 1999. We have previously published our experience during the first 10 years of the PROGRAM. Since 2010, 3 newly developed antiretroviral agents have been added to the PROGRAM:darunavir, etravirine, and raltegravir. The objective of this analysis is to describe the performance of participating laboratories measuring these newer agents in 2011-2012. MATERIALS AND METHODS:Each year, laboratories received 2 blind samples of human plasma/serum spiked with a low (<1.0 mg/L), medium (1.0-5.0 mg/L), or high (>5.0 mg/L) concentration of these drugs. Laboratory results were standardized to percentages with reference to the nominal (true) concentration. Any result that deviated more than 20% of the nominal values was defined as inaccurate. RESULTS:The numbers of laboratories that participated by the end of 2012 were 44 for darunavir, 28 for etravirine, and 30 for raltegravir. A total of 357 results were evaluable for analysis. Of these, 64 (17.9%) results were reported with >20% deviation, so "inaccurate" (7.6% too low, 10.4% too high). The proportion of inaccurate results in 2011 was 21.3% for darunavir, 31.0% for etravirine, and 26.3% for raltegravir; in 2012, these figures improved to 8.1%, 23.2%, and 8.3% for darunavir, etravirine, and raltegravir, respectively. Taking darunavir as the reference, performance for etravirine was significantly lower [odds ratio = 0.462, 95% confidence interval: 0.246-0.866, P = 0.016] and performance for raltegravir was not significantly different. Low concentrations were significantly more frequently reported as inaccurate than medium or high concentrations: 28.6% versus 10.6% versus 8.8%, respectively (P < 0.001). Laboratories that used Liquid Chromatography with tandem Mass Spectrometry did not perform better than those using High Performance Liquid Chromatography/Ultrarapid Performance Liquid Chromatography: 41 inaccurate results in 200 samples (20.5%) versus 23 in 157 samples (14.6%, P = 0.154). Multiple logistic regression revealed that the concentration range was the only significant predictor of inaccurate results. The lower range of concentrations performed worse than medium or high concentrations (P < 0.001). CONCLUSIONS:Laboratories continue to have problems with adequately measuring low plasma concentrations of antiretroviral agents. This is particularly a problem for some of the newer antiretroviral agents with plasma concentrations in the <1.0 mg/L range, such as etravirine and raltegravir.
journal_name
Ther Drug Monitjournal_title
Therapeutic drug monitoringauthors
Burger D,Krens S,Robijns K,Aarnoutse R,Brüggemann R,Touw Ddoi
10.1097/FTD.0000000000000089subject
Has Abstractpub_date
2014-12-01 00:00:00pages
824-7issue
6eissn
0163-4356issn
1536-3694journal_volume
36pub_type
杂志文章abstract:BACKGROUND:To increase target attainment rates, switching the mode of administration from intermittent (InI) to continuous infusion (CoI) has been proposed. In this study, target attainment rates and interpatient variation in exposure were compared between vancomycin InI- and CoI-treated critically ill patients. METHO...
journal_title:Therapeutic drug monitoring
pub_type: 杂志文章
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journal_title:Therapeutic drug monitoring
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abstract::Specific chromatographic methods for the measurement of cyclosporin A, tacrolimus, sirolimus, and everolimus blood levels in patients with organ transplants are time consuming when large numbers of samples must be processed. The authors developed a robust and fast (1 minute) online solid-phase extraction liquid chroma...
journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
pub_type: 临床试验,杂志文章
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abstract::A method is described for the determination of vigabatrin in 50 microliters of plasma by isocratic high-performance liquid chromatography using fluorescence detection. The procedure involves protein precipitation with methanol followed by precolumn derivatisation with o-phthaldialdehyde reagent. Separation of the deri...
journal_title:Therapeutic drug monitoring
pub_type: 杂志文章
doi:10.1097/00007691-199105000-00011
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journal_title:Therapeutic drug monitoring
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abstract:BACKGROUND:Drug blood levels can only serve as a surrogate because of the lack of information on the drug's direct pharmacological effects in the individual patient. Measurement of the mammalian target of rapamycin (mTOR) activity dependent on the phosphorylation status of p70 S6 kinase (p70 S6K) offers a practical way...
journal_title:Therapeutic drug monitoring
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abstract::Lidocaine has a concentration-dependent effect on seizures. At lower concentrations it has anticonvulsant properties, whereas concentrations above 15 microg/mL frequently result in seizures in laboratory animals and man. Seizures induced by lidocaine in experimental conditions invariably start in the amygdala. Despite...
journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
pub_type: 杂志文章,多中心研究
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更新日期:2006-10-01 00:00:00
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journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
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abstract::Despite its known teratogenic effects, thalidomide has been used to treat a variety of diseases ranging from alleviation of autoimmune disorders to prevention of metastasis of cancers. The exact method of action of thalidomide and its derivatives is still under investigation. Thalidomide undergoes very little metaboli...
journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
pub_type: 临床试验,杂志文章
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journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
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doi:10.1097/00007691-199109000-00012
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journal_title:Therapeutic drug monitoring
pub_type: 杂志文章
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journal_title:Therapeutic drug monitoring
pub_type: 杂志文章
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journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
pub_type: 杂志文章
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更新日期:2008-12-01 00:00:00
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journal_title:Therapeutic drug monitoring
pub_type: 杂志文章
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更新日期:2004-04-01 00:00:00
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journal_title:Therapeutic drug monitoring
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doi:10.1097/00007691-200108000-00020
更新日期:2001-08-01 00:00:00
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journal_title:Therapeutic drug monitoring
pub_type: 杂志文章
doi:10.1097/00007691-199808000-00014
更新日期:1998-08-01 00:00:00
abstract::This investigation was designed to compare three assay techniques, the traditional bioassay (agar diffusion), and two more recent techniques, high-performance liquid chromatography (HPLC) and fluorescence polarization immunoassay (FPIA), for the determination of vancomycin concentrations in serum. One hundred clinical...
journal_title:Therapeutic drug monitoring
pub_type: 杂志文章
doi:10.1097/00007691-198406000-00019
更新日期:1984-01-01 00:00:00
abstract::A 64-year-old man with chronic renal insufficiency was hospitalized with dysphagia and inability to keep his head erect 11 months after beginning procainamide hydrochloride (PA) for control of atrial flutter. Evaluation revealed esophageal dysmotility, worsening renal function, and elevated serum PA and N-acetylprocai...
journal_title:Therapeutic drug monitoring
pub_type: 杂志文章
doi:10.1097/00007691-199306000-00013
更新日期:1993-06-01 00:00:00