Inter-laboratory Analysis of Isavuconazole Plasma Concentration Assays Among European Laboratories

Federico Pea, Robert Krause, Carsten Muller, Benjamin Hennart, Malcolm Richardson, Andreas Meinitzer, Martin H. J. Wiesen, Tatiana Wiktorowicz, Jochen Spickermann, Anne Santerre Henriksen

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Background: Under certain circumstances, clinicians treating patients with isavuconazole for invasive aspergillosis or mucormycosis may use therapeutic drug monitoring. However, the accuracy and reproducibility of the various assays used by different laboratories for the quantification of isavuconazole plasma concentrations have yet to be determined.
Methods: Human plasma samples spiked with known concentrations of isavuconazole were provided to European laboratories that took part in a “round-robin” test (an inter-laboratory test performed independently at least two times; two rounds performed in the current study). Assay methods included liquid chromatography-tandem mass spectrometry (LC-MS/MS), LC with ultraviolet detection (LC-UV), LC with fluorescence detection (LC-FL), and bioassay. The accuracy and reproducibility compared with the known concentrations for each sample in each round were compared overall, between assays, and between laboratories.
Results: Twenty-seven laboratories participated in the study (LC-MS/MS, n=15; LC-UV; n=9; LC-FL, n=1; bioassay, n=2). In Round 1, for nominal concentrations of 1000, 1700, 2500, and 4000 ng/mL, the mean (SD) determined concentrations were 1007 (183), 1710 (323), 2528 (540), and 3898 (842) ng/mL, respectively. In Round 2, for nominal concentrations of 1200, 1800, 2400, and 4000 ng/mL, the mean (SD) determined concentrations were 1411 (303), 2111 (409), 2789 (511), and 4723 (798) ng/mL, respectively. Over both rounds, determined concentrations were consistently within 15% of the nominal concentrations for 10 laboratories (LC-MS/MS, n=4; LC-UV, n=5; bioassay, n=1) and consistently exceeded the upper 15% margin for 7 laboratories (LC-MS/MS and LC-UV, n=3 each; LC-FL, n=1).
Conclusions: Alignment of methodologies among laboratories may be warranted to improve accuracy and reproducibility of therapeutic drug measurements.
Original languageEnglish
JournalTherapeutic Drug Monitoring
Early online date31 Mar 2019
Publication statusPublished - 2019


  • Bioassay
  • isavuconazole
  • LC-FL
  • LC-MS/MS
  • LC-UV


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