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The aim of this work was to compare a validated liquid chromatography-mass spectrometry (LC-MS) method with the commercial enzyme multiplied immunoassay technique (EMIT) for cyclosporine and tacrolimus whole blood quantification. Samples of transplant patients receiving cyclosporine (n=38) or tacrolimus (n=41) were analyzed successively by LC-MS and EMIT. Several statistical approaches for method comparison were evaluated and Passing-Bablok and Bland-Altman analyses chosen. Overestimations of the concentrations measured with EMIT compared to LC-MS were observed with means of 23% (range: 6% to 46%) for cyclosporine and 30% (range: -3% to 73%) for tacrolimus. The EMIT demonstrated significant positive biases due to cross-reactions with metabolites. This indicates that, in some clinical situations, a selective method such as LC-MS is preferable for therapeutic drug monitoring in transplant patients.

Citation

Nicolas Ansermot, Marc Fathi, Jean-Luc Veuthey, Jules Desmeules, Serge Rudaz, Denis Hochstrasser. Quantification of cyclosporine and tacrolimus in whole blood. Comparison of liquid chromatography-electrospray mass spectrometry with the enzyme multiplied immunoassay technique. Clinical biochemistry. 2008 Jul;41(10-11):910-3

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PMID: 18358833

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