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Published on: December 18, 2013
[Treatment with sustained theophylline release. Monitoring by salivary assay in children]
E Bidat1, A Leneveu, P Aergerter
1Service de Pédiatrie, Hôpital Ambroise-Paré, Boulogne.
Insights
Salivary theophylline assays can replace plasma assays for monitoring asthmatic children
Area of Science:
- Clinical Pharmacology
- Pediatric Pulmonology
- Biomarker Analysis
Context:
- Monitoring theophylline therapy in asthmatic children is crucial for effective treatment.
- Traditional plasma assays can be invasive and burdensome for pediatric patients.
- Sustained-release theophylline formulations require regular therapeutic drug monitoring.
Purpose:
- To evaluate the feasibility of using salivary theophylline concentrations as a non-invasive alternative to plasma assays.
- To establish a correlation between plasma and salivary theophylline levels in pediatric asthmatic patients.
- To determine the accuracy of salivary assays for therapeutic drug monitoring.
Summary:
- This study investigated the replacement of plasma theophylline assays with salivary assays in 73 asthmatic children undergoing sustained-release theophylline therapy.
- Simultaneous plasma and saliva samples were collected and analyzed using the EMIT method.
- A strong correlation (P < 0.0001) was found between plasma (P) and salivary (S) theophylline concentrations (P = 1.58 S + 8.7).
- Calculated plasma concentrations from salivary measurements showed a mean difference of 7.1 ± 9 μmol/l compared to measured values.
Impact:
- Salivary theophylline assays offer a non-invasive and painless method for monitoring pediatric asthma patients.
- This approach can improve patient compliance and facilitate dosage adjustments.
- The findings support the use of salivary assays under strict conditions for verifying compliance and managing theophylline dosage.
Abstract:
We have tested the possibility of replacing plasma assays by salivary assays of theophylline for the monitoring of sustained-release theophylline therapy in asthmatic children. In a first group of 40 children aged 7.2 +/- 3.3 years (mean +/- SD) treated with sustained-release theophylline in mean daily doses of 18.8 +/- 5 mg/kg, 77 plasma and saliva samples were taken simultaneously 6 hours after the morning dose (6 H). Saliva was collected after mouth-wash and stimulation with 10 mg of citric acid. Assays were performed using the EMIT method. Theophylline plasma concentrations (P) and salivary concentrations (S), both expressed as mumol/l, were found to correlate: P = 1.58 S + 8.7 (P less than 0.0001). In a second group of 33 children, 39 simultaneous samples were taken at 6 H. From the equation previously obtained the plasma concentration corresponding to each salivary concentration was calculated, and the calculated value was compared with the measured value. The difference between the two values was 7.1 +/- 9 mumol/l. On this basis, and because the method is non-invasive and painless, were are now using salivary assays (under strict conditions of collection and measurement) to verify the patients' compliance and to maintain or adjust dosage in asthmatic children.
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