Point of care assay for blood aripiprazole concentrations: development, validation and utility

• Published in: British journal of psychiatry 2023-08, Vol.223 (2), p.389-393
• Main Authors: Atkins, Matthew, Taylor, David, Catalan, Ana, Desouza, Neville, Chesney, Edward, Reilly, Thomas J., Baburina, Irina, Hilaire, Mary Rose, Dratcu, Luiz, Harland, Robert, Salamone, Salvatore J., McGuire, Philip
• Format: Article
• Language: English
• Subjects: Antipsychotic Agents - therapeutic use; Antipsychotics; Aripiprazole; Blood levels; Blood tests; Clinical assessment; Dosage; Humans; Immunoassay; Laboratories; Measurement; Patients; Plasma; Point-of-Care Systems; Psychiatry; Psychosis; Psychotropic drugs; Reagents; Technology and Mental Health
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.2023.58

The antipsychotic aripiprazole is often used in the treatment of first-episode psychosis. Measuring aripiprazole blood levels provides an objective measure of treatment adherence, but this currently involves taking a venous blood sample and sending to a laboratory for analysis. To detail the development, validation and utility of a new point of care (POC) test for finger-stick capillary blood concentrations of aripiprazole. Analytical performance (sensitivity, precision, recovery and linearity) of the assay were established using spiked whole blood and control samples of varying aripiprazole concentration. Assay validation was performed over a 14-month period starting in July 2021. Eligible patients were asked to provide a finger-stick capillary sample in addition to their usual venous blood sample. Capillary blood samples were tested by the MyCare™ Insite POC analyser, which provided measurement of aripiprazole concentration in 6 min, and the venous blood sample was tested by the standard laboratory method. A total of 101 patients agreed to measurements by the two methods. Venous blood aripiprazole concentrations as assessed by the laboratory method ranged from 17 to 909 ng/mL, and from 1 to 791 ng/mL using POC testing. The correlation coefficient between the two methods ( ) was 0.96 and there was minimal bias (slope 0.91, intercept 4 ng/ml). The MyCare Insite POC analyser is sufficiently accurate and reliable for clinical use. The availability of this technology will improve the assessment of adherence to aripiprazole and the optimising of aripiprazole dosing.