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- Title
Therapeutic Drug Monitoring of Second- and Third-Generation Antiepileptic Drugs: Insights From a College of American Pathologists Proficiency Testing Survey.
- Authors
Krasowski, Matthew D.; Long, Thomas A.; Snozek, Christine L. H.; Dizon, Annabel; Magnani, Barbarajean; Melanson, Stacy E. F.
- Abstract
Context.--Therapeutic drug monitoring has traditionally been widely used for first-generation antiepileptic drugs (AEDs) such as carbamazepine and phenytoin. The last 2 decades have seen the introduction of second- and thirdgeneration AEDs (eg, lamotrigine, levetiracetam, and topiramate) into clinical practice. Objective.--To use data from the College of American Pathologists Therapeutic Drug Monitoring, Extended Proficiency Testing Survey to determine the performance of assays used for therapeutic drug monitoring of newer AEDs, including comparison of enzyme immunoassay and chromatographic techniques. Design.--Six years of proficiency testing surveys were reviewed (2013-2018). Results.--Steady growth was seen in participant volumes for newer AEDs. The analytical performance of automated enzyme immunoassays for lamotrigine, levetiracetam, and topiramate was similar to that of chromatographic methods, consistent with published literature using patient samples for comparisons. The majority of participating laboratories now use enzyme immunoassays to measure levetiracetam. Conclusions.--Survey results reflect steadily growing interest in therapeutic drug monitoring of newer AEDs. The increasing availability of robust immunoassays for new AEDs should facilitate their clinical utility, especially for clinical laboratories that do not perform chromatographic assays for therapeutic drug monitoring.
- Subjects
ANTICONVULSANTS; LAMOTRIGINE; HETEROCYCLIC compounds; DRUG monitoring; IMMUNOENZYME technique; CHROMATOGRAPHIC analysis; SECONDARY analysis; TOPIRAMATE
- Publication
Archives of Pathology & Laboratory Medicine, 2021, Vol 145, Issue 12, p1485
- ISSN
0003-9985
- Publication type
Article
- DOI
10.5858/arpa.2020-0562-CP