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LC-MS method guarantees safer hydroxychloroquine dosage per individual

 


    LC-MS method guarantees safer hydroxychloroquine dosage per individual

Side effects can be fatal even if hydroxychloroquine proves to be an effective treatment for COVID-19. In a recent study, researchers at Uppsala University found a workaround to adjust the hydroxychloroquine dose for each patient based on a whole blood test.

Originally developed to treat malaria, hydroxychloroquine has been shown to be effective in systemic lupus erythematosus and rheumatoid arthritis. In fact, it protects against flares of illness so well that it is currently recommended for all lupus patients. However, as seen by patients with malaria, the side effect of hydroxychloroquine, a problem of heart rhythm, is common and can be fatal.

After confirming that the levels of hydroxychloroquine differed significantly between individuals on the same dosing regimen, Uppsala researchers found that liquid chromatography-high-resolution mass spectrometry ( LC-HRMS) method was developed.

In this study, The researchers compared the levels of hydroxychloroquine in plasma, serum, and whole blood of 26 lupus patients. The variability between the three matrices was unexpectedly high, with hydroxychloroquine levels in whole blood approximately twice that in serum and plasma.

“One of the surprising results, and as a very important insight, the whole blood levels of patients prescribed the same dose can vary up to 15 times between individuals. This is how the drug is metabolized. There is a large individual difference,” said Kim Kurtima of the study authors Uppsala University and Uppsala University Hospital.

Therefore, after validation and application at both clinical and laboratory levels, researchers believe that whole blood is an excellent matrix and should be used for hydroxychloroquine analysis in monitoring patient therapeutic efficacy. I made a conclusion.

The LC-HRMS method has been used at Uppsala University Hospital since December 2019. The total chromatography time is only 4 minutes and the researchers report that it shows good linearity.

“Measurement of hydroxychloroquine in routine care helps clinicians motivate patients and improve treatment adherence and adjust doses accordingly, avoiding unnecessary addition of more toxic treatments. It also helps to monitor HCQ levels to minimize the risk of long-term side effects.” Research and treatment of arthritis..

The researchers warn that this method of analysis has proven effective in providing correct doses only to lupus patients, not to COVID-19 patients.

“We need to be very careful about making urgent conclusions about whether hydroxychloroquine is effective for COVID-19,” Kultima said.

That said, patients at Uppsala University Hospital would not want to be alert if hydroxychloroquine was indeed found to be effective against COVID-19. Researchers are now planning to work with doctors at infectious disease clinics and intensive care units at Uppsala University Hospital to enable rapid determination of hydroxychloroquine levels in the blood of COVID-19 patients. Confirming. It proves to be fruitful.

If the substance is found to be effective, be prepared to measure the drug level in the blood of COVID-19 patients.

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