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Personalized Drug Therapy: From Therapeutic Drug Monitoring to Clinical Outcome

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pharmacology".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 5607

Special Issue Editors


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Guest Editor
Department of Drug Chemistry, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland
Interests: therapeutic and pharmacokinetic drug monitoring; personalized medicine; immunosuppressive drugs

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Guest Editor
Bioanalysis and Drugs Analysis Department, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland
Interests: bioanalysis; liquid chromatography coupled to mass spectrometry; sample preparation; metabolomics
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Co-Guest Editor
Department of Physical Pharmacy and Pharmacokinetics, Poznań University of Medical Sciences, Rokietnicka 3 Street, 60-806 Poznań, Poland
Interests: therapeutic drug monitoring; drug analysis; pharmacokinetics; optimization of analytical procedure; drug-drug interactions
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Personalized therapy is a type of targeted treatment. It helps treat a wide range of diseases such as cancer, autoimmune diseases, and immunosuppressive therapy. It has many advantages over conventional medicine. This is because it enables the selection of the optimal therapy, thereby increasing its safety and efficacy, reducing adverse drug reactions, increasing patient compliance, and reducing the cost, time, and failure rate of clinical trials. Personalized medicine owes its development to innovative therapies, advances in genomics, metabolomics and other omics sciences, and modern analytical methods. Personalized therapy uses biomarkers, including modern tools from the -omic sciences, to predict the outcome of therapy in many diseases. An example of drugs that require personalized therapy is immunosuppressive drugs used to treat organ transplant patients. These have very complex and variable pharmacokinetics. In addition, personalized therapy with these drugs is necessary because of narrow therapeutic ranges, significant variability in blood concentrations among patients, sex differences in drug metabolism, and drug interactions.

The Special Issue “Personalized drug therapy: from therapeutic drug monitoring to clinical outcome” of the International Journal of Molecular Sciences welcomes both original research and review papers. Clinical and model submissions, with biomolecular experiments and some validation data for biological experiments, respectively, are welcomed. We will consider articles in the broad field of personalized therapy. In particular, we would like to discuss the differences between targeted and personalized therapy as a new treatment and therapeutic option. It should be emphasized that before and during the personalized therapy procedure, the analysis should be focused on each patient for whom treatment is being developed. Suggested manuscript topics are listed below.

Suggested topics:

  1. Drug combination effects and the impact of gene profiling on pharmacokinetics and pharmacological responses;
  2. The value of biomarkers in optimizing personalized therapy, including the use of modern tools from the field of, e.g., pharmacometabolomics;
  3. Correlation between drug concentration and clinical outcome;
  4. Development of analytical methods based on new sorbents and their application for monitoring drug concentrations in personalized therapy.

Dr. Tomasz Pawiński
Dr. Joanna Giebułtowicz
Dr. Andrzej Czyrski
Guest Editors

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Keywords

  • personalized therapy
  • therapeutic drug monitoring
  • pharmacokinetics variability
  • liquid chromatography coupled to mass spectrometry
  • immunosuppressive therapy
  • anticancer therapy
  • genetics
  • clinical setting
  • rheumatoid arthritis
  • analytical methods
  • metabolomics
  • pharmacometabolomics
  • biomarkers
  • thyrosine kinase inhibitors

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Published Papers (2 papers)

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Research

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12 pages, 1295 KiB  
Article
Saliva as Blood Alternative in Therapeutic Monitoring of Teriflunomide—Development and Validation of the Novel Analytical Method
by Bartłomiej Sankowski, Sylwia Michorowska, Emilia Raćkowska, Mariusz Sikora and Joanna Giebułtowicz
Int. J. Mol. Sci. 2022, 23(17), 9544; https://doi.org/10.3390/ijms23179544 - 23 Aug 2022
Cited by 5 | Viewed by 2188
Abstract
Therapeutic drug monitoring (TDM) is extremely helpful in individualizing dosage regimen of drugs with narrow therapeutic ranges. It may also be beneficial in the case of drugs characterized by serious side effects and marked interpatient pharmacokinetic variability observed with leflunomide and its biologically [...] Read more.
Therapeutic drug monitoring (TDM) is extremely helpful in individualizing dosage regimen of drugs with narrow therapeutic ranges. It may also be beneficial in the case of drugs characterized by serious side effects and marked interpatient pharmacokinetic variability observed with leflunomide and its biologically active metabolite, teriflunomide. One of the most popular matrices used for TDM is blood. A more readily accessible body fluid is saliva, which can be collected in a much safer way comparing to blood. This makes it especially advantageous alternative to blood during life-threatening SARS-CoV-2 pandemic. However, drug’s saliva concentration is not always a good representation of its blood concentration. The aim of this study was to verify whether saliva can be used in TDM of teriflunomide. We also developed and validated the first reliable and robust LC-MS/MS method for quantification of teriflunomide in saliva. Additionally, the effect of salivary flow and swab absorptive material from the collector device on teriflunomide concentration in saliva was evaluated. Good linear correlation was obtained between the concentration of teriflunomide in plasma and resting saliva (p < 0.000016, r = 0.88), and even better between plasma and the stimulated saliva concentrations (p < 0.000001, r = 0.95) confirming the effectiveness of this non-invasive method of teriflunomide’s TDM. The analyzed validation criteria were fulfilled. No significant influence of salivary flow (p = 0.198) or type of swab in the Salivette device on saliva’s teriflunomide concentration was detected. However, to reduce variability the use of stimulated saliva and synthetic swabs is advised. Full article
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Review

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25 pages, 3774 KiB  
Review
Volumetric Absorptive Microsampling in Therapeutic Drug Monitoring of Immunosuppressive Drugs—From Sampling and Analytical Issues to Clinical Application
by Arkadiusz Kocur and Tomasz Pawiński
Int. J. Mol. Sci. 2023, 24(1), 681; https://doi.org/10.3390/ijms24010681 - 30 Dec 2022
Cited by 12 | Viewed by 2702
Abstract
Miniaturisation and simplification are novel approaches in clinical bioanalysis, especially in therapeutic drug monitoring (TDM). These contemporary trends are related to the sampling, pre-treatment, and analysis of biological fluids. Currently, dried blood spot (DBS), one of the most popular microsampling techniques, is feasible [...] Read more.
Miniaturisation and simplification are novel approaches in clinical bioanalysis, especially in therapeutic drug monitoring (TDM). These contemporary trends are related to the sampling, pre-treatment, and analysis of biological fluids. Currently, dried blood spot (DBS), one of the most popular microsampling techniques, is feasible and inexpensive. However, obtaining reliable results with sample homogeneity and volume variability is difficult. Volumetric Absorptive Microsampling (VAMS) has recently enabled the accurate and precise collection of a fixed blood volume. It reduced the hematocrit effect, improved volumetric accuracy, and generated results correlating with the dose and drug exposure from wet blood. This review focuses on VAMS-Mitra™ devices, which have become increasingly important since 2014, mainly for TDM and toxicology studies. First, the current literature has been reviewed based on immunosuppressants and their determination in samples obtained using Mitra™. Second, the critical points, weaknesses, and strengths have been characterized in contrast to classic venipuncture and other microsampling methods. Finally, we indicate the points of attention according to the perspective of Mitra™ as well as its usefulness in clinical practice. VAMS is currently state-of-the-art in microsampling and seems to be a good instrument for improving adherence to immunosuppressive therapy, especially in the pediatric population. Full article
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