PMID: 15228170Jul 2, 2004Paper

Analytic aspects of cyclosporine monitoring, on behalf of the IFCC/IATDMCT Joint Working Group

Therapeutic Drug Monitoring
Raymond G MorrisIFCC/IATDMCT Joint Working Group

Abstract

The use of therapeutic drug monitoring strategies for cyclosporin (CsA) has evolved markedly in recent years since previous consensus guidelines were presented. Apart from the introduction of some new methods, the major change has been the shift away from the traditional predose/trough (C0) sample. The most popular alternative has been shown to be a 2-hour postdose (C2) sample. This has presented a challenge to clinical laboratories where typical C2 sample concentrations exceed the upper limit of the calibration range for their chosen CsA method, hence requiring an accurate dilution to be performed. Data from the Australian/New Zealand survey, as well as that in the International CsA Proficiency Testing Program, have demonstrated both a plethora of dilution protocols and resultant widespread failure of many laboratories to obtain accurate results. This paper compares data from several independent sources, pointing to international problems for reliable CsA measurement in clinical laboratories. This includes the CsA method selection criteria adopted by a large percentage of laboratories in various surveys, indicating that the least specific mFPIA methods have been widely adopted.

References

Jan 24, 2002·Therapeutic Drug Monitoring·David W HoltUNKNOWN Clinical Toxicology working group on immunosuppressive drug monitoring
Jul 27, 2002·Therapeutic Drug Monitoring·Raymond G Morris, Ada K Lam
Nov 27, 2002·Therapeutic Drug Monitoring·Raymond G MorrisStephen Cook
Jan 11, 2003·Archives of Pathology & Laboratory Medicine·Steven J SoldinUNKNOWN College of American Pathologists Study
Mar 27, 2003·Therapeutic Drug Monitoring·Atholl JohnstonDavid W Holt

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Citations

Mar 2, 2010·Clinica Chimica Acta; International Journal of Clinical Chemistry·Steven J SoldinMichael Oellerich
Dec 14, 2004·The Annals of Pharmacotherapy·Raymond G Morris
Sep 2, 2006·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Eveline Jaquenoud SirotPierre Baumann
Apr 30, 2011·Clinical Chemistry·Andreas PeterIngo Müller
May 21, 2005·Therapeutic Drug Monitoring·Ian S WestleyMaree J James
Mar 22, 2014·Therapeutic Drug Monitoring·Michael VogeserAlain G Verstraete

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