Academic Journal

Factors to influence the accuracy of albumin adjusted free valproic acid concentration

التفاصيل البيبلوغرافية
العنوان: Factors to influence the accuracy of albumin adjusted free valproic acid concentration
المؤلفون: Yu-Ju Tseng, Shih-Ying Huang, Chih-Hsuan Kuo, Chen-Yu Wang, Kuo-Chuan Wang, Chien-Chih Wu
المصدر: Journal of the Formosan Medical Association, Vol 120, Iss 4, Pp 1114-1120 (2021)
بيانات النشر: Elsevier, 2021.
سنة النشر: 2021
المجموعة: LCC:Medicine (General)
مصطلحات موضوعية: Therapeutic drug monitoring, Valproic acid, Accuracy, Albumin, Free concentration, Medicine (General), R5-920
الوصف: Background: Therapeutic drug monitoring (TDM) is recommended during treatment with valproic acid (VPA), as is the measurement of free VPA concentration (MfVPA). However, MfVPA is unavailable in many institutions. Based on the highly protein-bound characteristics of VPA, an albumin-adjusted formula has been proposed to predict free VPA concentration (PfVPA). Nevertheless, the factors affecting the accuracy of this formula remain unknown, as does the concordance between MfVPA and PfVPA. Methods: Adult patients receiving VPA and undergoing TDM were enrolled. Free and total serum concentration (TVPA) were categorized as subtherapeutic, therapeutic, or supratherapeutic based on the reference range of 5–15 and 50–100 μg/mL, respectively. Concordance was defined as MfVPA and PfVPA, or MfVPA and TVPA, falling within the same category. Multivariate logistic regression with generalized estimating equation was adopted to identify factors affecting concordance, and the receiver operating characteristic curve was applied to determine the cutoff values of predictors. Results: A total of 98 data points from 51 participants were included for analysis. The concordance of MfVPA and PfVPA, and MfVPA and TVPA, was 72% and 44%, respectively. Blood urea nitrogen (BUN) (0.97 [0.95–0.99], P = 0.01) and TVPA (0.97 [0.95–0.99], P = 0.02) had a significant influence on the concordance of MfVPA and PfVPA. The cutoff values of TVPA and BUN for the accuracy of the albumin-adjusted formula were 56.4 μg/mL and 51.05 mg/dL, respectively. Conclusion: If MfVPA is not available, the albumin-adjusted formula should be applied before VPA dosage adjustment when TVPA is
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 0929-6646
Relation: http://www.sciencedirect.com/science/article/pii/S0929664620304277; https://doaj.org/toc/0929-6646
DOI: 10.1016/j.jfma.2020.09.004
URL الوصول: https://doaj.org/article/6a8c1a8875f34ca08481a3a154873e6e
رقم الانضمام: edsdoj.6a8c1a8875f34ca08481a3a154873e6e
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:09296646
DOI:10.1016/j.jfma.2020.09.004