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Development of a precise quantitative method for monitoring sirolimus in whole blood using LC/ESI–MS/MS
Authors:Kensuke Shigeta  Masafumi Kikuchi  Masaki Tanaka  Shinya Takasaki  Hisashi Oishi  Tetsu Sado  Yasushi Matsuda  Masafumi Noda  Yoshinori Okada  Nariyasu Mano  Hiroaki Yamaguchi
Institution:1. Faculty of Pharmaceutical Sciences, Tohoku University, Sendai, Japan;2. Faculty of Pharmaceutical Sciences, Tohoku University, Sendai, Japan

Department of Pharmaceutical sciences, Tohoku University Hospital, Sendai, Japan;3. Department of Pharmaceutical sciences, Tohoku University Hospital, Sendai, Japan;4. Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan

Abstract:Sirolimus is used on patients after solid organ transplantation and on lymphangioleiomyomatosis (LAM) patients, and therapeutic drug monitoring is required in clinical practice. We have previously reported an accurate method for quantitative determination of sirolimus, but its sample preparation step was complicated. In this study, we developed a modified liquid chromatography/electrospray ionization tandem mass spectrometry (LC/ESI–MS/MS) method for sirolimus quantification. A supported liquid extraction cartridge was used to purify sirolimus from whole blood and ion suppression was mostly prevented. The validation results met the acceptance criteria. This method was compared with the antigen conjugated magnetic immunoassay (ACMIA) and our previously reported method, using whole blood samples from LAM patients. Comparison of the Bland–Altman plots of the currently developed method and the previous method revealed no significant difference between the two methods (mean bias, −2.02%; 95% CI, −7.81–3.78). The values obtained using ACMIA were significantly higher than those obtained using the current method by 13.87% (95% CI, 6.49–21.25) owing to cross-reactivity. The degrees of cross reactivities in LAM patients and in organ transplant patients were similar, and our LC/ESI–MS/MS method precisely measured the blood concentrations of sirolimus.
Keywords:ACMIA  LC/ESI–MS/MS  lymphangioleiomyomatosis  sirolimus  therapeutic drug monitoring
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