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Patient-led Remote IntraCapillary pharmacoKinetic Sampling (fingerPRICKS) for Therapeutic Drug Monitoring in patients with Inflammatory Bowel Disease.
Chee, Desmond; Nice, Rachel; Hamilton, Ben; Jones, Edward; Hawkins, Sarah; Redstone, Clare; Cairnes, Vida; Pohl, Keith; Chanchlani, Neil; Lin, Simeng; Kennedy, Nicholas A; Ahmad, Tariq; Goodhand, James R; McDonald, Timothy J.
  • Chee D; Exeter Inflammatory Bowel Disease and Pharmacogenetics Group, University of Exeter, Exeter, UK.
  • Nice R; Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK.
  • Hamilton B; Exeter Inflammatory Bowel Disease and Pharmacogenetics Group, University of Exeter, Exeter, UK.
  • Jones E; Department of Biochemistry, Exeter Clinical Laboratory International, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK.
  • Hawkins S; Exeter Inflammatory Bowel Disease and Pharmacogenetics Group, University of Exeter, Exeter, UK.
  • Redstone C; Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK.
  • Cairnes V; University of Bath, Bath, UK.
  • Pohl K; Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK.
  • Chanchlani N; Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK.
  • Lin S; Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK.
  • Kennedy NA; Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK.
  • Ahmad T; Exeter Inflammatory Bowel Disease and Pharmacogenetics Group, University of Exeter, Exeter, UK.
  • Goodhand JR; Department of Gastroenterology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK.
  • McDonald TJ; Exeter Inflammatory Bowel Disease and Pharmacogenetics Group, University of Exeter, Exeter, UK.
J Crohns Colitis ; 16(2): 190-198, 2022 Feb 23.
Article in English | MEDLINE | ID: covidwho-1319160
ABSTRACT
BACKGROUND AND

AIMS:

Because of COVID-19 public health restrictions, telemedicine has replaced conventional outpatient follow up for most patients with chronic immune-mediated inflammatory disorders treated with biologic drugs. Innovative solutions to facilitate remote therapeutic drug monitoring are therefore required. Low-volume intracapillary blood sampling can be undertaken by patients at home and samples returned by post to central laboratories. We sought to report the effect of the COVID-19 pandemic on requests for therapeutic drug monitoring and the equivalence, acceptability and effectiveness of low volume Patient-led Remote IntraCapillary pharmacoKinetic Sampling [fingerPRICKS] compared to conventional venepuncture.

METHODS:

We undertook a cross-sectional blood sampling methods comparison study and compared sample types using linear regression models. Drug and antidrug antibody levels were measured using standard ELISAs. Acceptability was assessed using a purpose-designed questionnaire.

RESULTS:

Therapeutic drug monitoring requests for adalimumab (96.5 [70.5-106] per week to 52 [33.5-57.0], p < 0.001) but not infliximab (184.5 [161.2-214.2] to 161 [135-197.5], p = 0.34) reduced during the first UK stay-at-home lockdown compared with the preceding 6 months. Fingerprick sampling was equivalent to conventional venepuncture for adalimumab, infliximab, vedolizumab and ustekinumab drug, and anti-adalimumab and anti-infliximab antibody levels. The median [interquartile range] volume of serum obtained using intracapillary sampling was 195 µL [130-210]. More than 87% [90/103] of patients agreed that intracapillary testing was easy and 69% [71/103] preferred it to conventional venepuncture. In routine care, 75.3% [58/77] of patients returned two blood samples within 14 days to permit remote assessment of biologic therapeutic drug monitoring.

CONCLUSIONS:

Therapeutic drug monitoring can be undertaken using patient-led remote intracapillary blood sampling and has the potential to be a key adjunct to telemedicine in patients with immune-mediated inflammatory diseases.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Inflammatory Bowel Diseases / Drug Monitoring / Self-Testing Type of study: Prevalence study / Randomized controlled trials / Risk factors Limits: Humans Country/Region as subject: Europa Language: English Journal: J Crohns Colitis Journal subject: Gastroenterology Year: 2022 Document Type: Article Affiliation country: Ecco-jcc

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Inflammatory Bowel Diseases / Drug Monitoring / Self-Testing Type of study: Prevalence study / Randomized controlled trials / Risk factors Limits: Humans Country/Region as subject: Europa Language: English Journal: J Crohns Colitis Journal subject: Gastroenterology Year: 2022 Document Type: Article Affiliation country: Ecco-jcc