Performance of the New RapidFire System for Therapeutic Monitoring of Immunosuppressants

Abstract

The RapidFire-MS/MS system provided convincing results measuring patient samples and quality control materials. Together with a high throughput and a high robustness, it could represent an alternative to LC-MS/MS instruments in therapeutic drug monitoring.

Therapeutic drug monitoring of immunosuppressants by liquid chromatography–mass spectrometry

“…The between-run CV was 1.8%-13.0% for cyclosporine A, tacrolimus, sirolimus, and everolimus. In another study, the analytical column was replaced with a solid-phase extraction cartridge; thus completely avoiding LC separation [49]. This lowered the analytical run time to 13 s. The assay was compared to an LC-MS/ MS method, showing 0.964 as the lowest Pearson correlation coefficient with Deming regression and 2.9% as the largest mean concentration difference.…”

“…Lastly, a fourth group found that differences in hematocrit (20% to 45%), spotted blood volume (25,35,50,75, and 100 μL), and punch location did not affect immunosuppressant quantitation [39]. [46,47] Online solid phase extraction (analytical run time of 1 min) [48] No LC separation (analytical run time of 13 s) [49] Liquid handler [50] Commercialization/ Standardization 7-Lab tacrolimus unification [52] 3-Lab cyclosporine A, tacrolimus, and sirolimus unification [53] Much of these DBS validation studies involve the deposition of venous blood from a collection tube onto the paper. Two recent studies evaluated capillary blood from a finger stick.…”

Recent advances in analytical methods for the therapeutic drug monitoring of immunosuppressive drugs

“…Several techniques have been developed to increase the throughput of LC–MS/MS. Among them, UPLC is one of the most commonly used techniques . UPLC increases the throughput by shortening the LC run time while retaining the resolution by using smaller‐diameter separation media and very high pressure.…”

“…Among them, UPLC is one of the most commonly used techniques. [33][34][35][36][37][38] Furthermore, sample preparation was simple, and this method could In addition to the blood samples for the TDM of ISDs, other potential and convenient specimens, including saliva, hair, and ocular fluids, have also been explored when whole-blood levels are within the therapeutic range. [47][48][49][50][51] Belostotsky et al 47…”

“…Examples of laboratory developed LC-MS/MS methods for immunosuppressive drugsPartial or full automation of sample preparation can not only reduce the analytical time but also improve the precision and accuracy [35][36][37][38]. Grote-Koska et al35 reported a new RapidFire system for the therapeutic monitoring of ISDs in whole blood that runs for a few minutes per sample. The analytical column was replaced with an SPE cartridge, thus completely avoiding LC separation.…”