Automated Interlaboratory Comparison of Therapeutic Drug Monitoring Data and Its Use for Evaluation of Published Therapeutic Reference Ranges

被引:3
|
作者
Larsen, Jens Borggaard [1 ]
Hoffmann-Lucke, Elke [2 ,3 ]
Aaslo, Per Hersom [4 ]
Jorgensen, Niklas Rye [5 ,6 ]
Greibe, Eva [2 ,3 ]
机构
[1] Datasupport Ctr Personalised Med, DK-5000 Odense, Denmark
[2] Aarhus Univ Hosp, Dept Clin Biochem, DK-8200 Aarhus, Denmark
[3] Aarhus Univ, Inst Clin Med, Hlth, DK-8000 Aarhus, Denmark
[4] Lab Danish Epilepsy Ctr Filadelfia, DK-4293 Dianalund, Denmark
[5] Rigshosp, Dept Clin Biochem, DK-2600 Glostrup, Denmark
[6] Univ Copenhagen, Fac Hlth & Med Sci, Dept Clin Med, DK-1165 Copenhagen, Denmark
关键词
therapeutic drug monitoring (TDM); therapeutic reference range; antidepressant; antipsychotic; big data; SERUM CONCENTRATIONS; PLASMA-CONCENTRATION; CLINICAL-RESPONSE; CYP2D6; GENOTYPE; CONSENSUS GUIDELINES; REDUCED HALOPERIDOL; PSYCHOTROPIC-DRUGS; TDM; AGE; PERPHENAZINE;
D O I
10.3390/pharmaceutics15020673
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Therapeutic drug monitoring is a tool for optimising the pharmacological treatment of diseases where the therapeutic effect is difficult to measure or monitor. Therapeutic reference ranges and dose-effect relation are the main requirements for this drug titration tool. Defining and updating therapeutic reference ranges are difficult, and there is no standardised method for the calculation and clinical qualification of these. The study presents a basic model for validating and selecting routine laboratory data. The programmed algorithm was applied on data sets of antidepressants and antipsychotics from three public hospitals in Denmark. Therapeutic analytical ranges were compared with the published therapeutic reference ranges by the Arbeitsgemeinschaft fur Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) and in additional literature. For most of the drugs, the calculated therapeutic analytical ranges showed good concordance between the laboratories and to published therapeutic reference ranges. The exceptions were flupentixol, haloperidol, paroxetine, perphenazine, and venlafaxine + o-desmethyl-venlafaxine (total plasma concentration), where the range was considerably higher for the laboratory data, while the calculated range of desipramine, sertraline, ziprasidone, and zuclopenthixol was considerably lower. In most cases, we identified additional literature supporting our data, highlighting the need of a critical re-examination of current therapeutic reference ranges in Denmark. An automated approach can aid in the evaluation of current and future therapeutic reference ranges by providing additional information based on big data from multiple laboratories.
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页数:19
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