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用自动化大数据方法评估血液样本中的抗发作药物度范围

Mariam Nersesjan¹, Elke Hoffmann-Lücke^2,3, Eva Greibe^2,3

¹Department of Clinical Pharmacology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.

|March 12, 2025

概括

丹麦抗发作药物的治疗药物监测 (TDM) 与当地范围一致,但与一些ASM的国际准则有差异. 年龄和适应症影响药物度,表明潜在的参考范围和剂量调整.

科学领域:

药理学药理学是指药理学的学科.
临床化学临床化学
神经学神经学

背景情况:

治疗药物监测 (TDM) 对于优化抗发作药物 (ASM) 疗效和安全至关重要.
关于ASM度的真实数据及其与已确定的参考范围的比较对于临床实践至关重要.
现有的参考范围可能无法完全捕捉药物代谢中特定人群的变化.

研究的目的:

分析丹麦常见的ASM的现实世界TDM数据.
将观察到的ASM度范围与已建立的丹麦,ILAE和AGNP参考范围进行比较.
调查年龄和适应症对ASM度的影响.

主要方法:

在五个丹麦实验室 (2019-2023) 分析了来自53,406名患者的84,951个TDM样本.
计算11个ASM的10至90百分位度范围.
观察到的范围与丹麦,ILAE和AGNP指南进行比较,按性别,年龄和指示分层.

主要成果:

观察到的和丹麦的参考范围之间的一致性很好,除了 levetiracetam.
观察到的范围和ILAE/AGNP关于布里瓦拉塞坦,拉科萨米德,拉莫特里金,莱维特拉塞坦,瓦尔酸和佐尼萨米德的指导方针之间的显著差异.
在几个ASM中观察到与年龄相关的度差异,在精神病患者中发现了较低的lamotrigine度.

结论:

自动化方法可以有效地将TDM数据集与持续监控的参考范围进行比较.
丹麦关于 levetiracetam 的参考范围需要重新评估.
对于 levetiracetam,topiramate和lacosamide,可能需要根据年龄进行剂量调整;较低的lamotrigine剂量可能在精神病患者群体中有效.

关键词:

抗发作药物抗发作药物是一种.一个回顾性队列队列.治疗药物监测治疗药物监测治疗参考范围的范围.

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