Point-of-Care Therapeutic Drug Monitoring for Precision Dosing of Immunosuppressive Drugs.

The Journal of Applied Laboratory Medicine
Adriano TaddeoMarc E Pfeifer

Abstract

Immunosuppressive drugs (ISD) are an essential tool in the treatment of transplant rejection and immune-mediated diseases. Therapeutic drug monitoring (TDM) for determination of ISD concentrations in biological samples is an important instrument for dose personalization for improving efficacy while reducing side effects. While currently ISD concentration measurements are performed at specialized, centralized facilities, making the process complex and laborious for the patient, various innovative technical solutions have recently been proposed for bringing TDM to the point-of-care (POC). In this review, we evaluate current ISD-TDM and its value, limitations, and proposed implementations. Then, we discuss the potential of POC-TDM in the era of personalized medicine, and provide an updated review on the unmet needs and available technological solutions for the development of POC-TDM devices for ISD monitoring. Finally, we provide concrete suggestions for the generation of a meaningful and more patient-centric process for ISD monitoring. POC-based ISD monitoring may improve clinical care by reducing turnaround time, by enabling more frequent measurements in order to obtain meaningful pharmacokinetic data (i.e., area under the curve...Continue Reading

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Citations

Jan 24, 2021·Analytical and Bioanalytical Chemistry·Ying LuoSuri S Iyer
Aug 17, 2021·Journal of Pharmaceutical and Biomedical Analysis·Behrouz Seyfinejad, Abolghasem Jouyban
Dec 23, 2021·Analytical and Bioanalytical Chemistry·Sara TombelliFrancesco Baldini

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