ArticleFrontiers in pharmacology2025
Comparison of oxcarbazepine metabolite concentrations measured by EMIT-based Siemens Viva-ProE
Article in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Therapeutic drug monitoring (TDM) of oxcarbazepine's active metabolite, the monohydroxy derivative (MHD), is essential for effective seizure management. Although liquid chromatography-tandem mass spectrometry (LC-MS/MS) is considered the gold standard for MHD quantification, its technical complexity restricts widespread clinical utility. The Siemens Viva-ProE Objectives: This study established and validated an LC-MS/MS method for quantifying MHD in plasma and assessed the correlation and concordance of SVPS measurements using concentration-specific Deming regression. The objective was to evaluate the feasibility of replacing LC-MS/MS with SVPS for TDM LC-MS/MS in clinical practice. Methods: A validated LC-MS/MS method (linear range: 0.18-39.30 μg/mL; intra/inter-day RSD < 15%) and SVPS (measurable range: 0.00-50.00 μg/mL) were applied to analyze 158 plasma samples. Correlation and concordance between the methods were assessed using Spearman's correlation, intraclass correlation coefficient (ICC), linear regression and Deming regression, Bland-Altman analysis, and Wilcoxon signed-rank tests. Stratified subgroup analyses, classified as low (<12 μg/mL), medium (12-22 μg/mL), and high (>22 μg/mL) concentration ranges, were conducted to evaluate the clinical acceptability of corrected SVPS values. Results: SVPS demonstrated a concentration-dependent positive bias (+13.04%) relative to LC-MS/MS. Despite this bias, strong overall correlation and concordance were observed ( Conclusion: While uncorrected SVPS results exhibit a systematic bias that produces direct interchangeability with LC-MS/MS, applying a concentration-specific Deming correction enables clinically reliable TDM of MHD at concentrations below 22 μg/mL. However, method optimization is still required for accurate quantification in the high-concentration range.
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