Hair analysis for monitoring adherence to inhaled respiratory medications: possibilities and limitations.

IF 2.7 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2025-09-09 DOI:10.1007/s00228-025-03903-w

Liz J A Cuperus, Wouter Ahmed, Johannes C C M In 't Veen, Huib A M Kerstjens, Tanja R Zijp, Jasper Stevens, A Mireille A Wessels, Daan J Touw, Job F M van Boven

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引用次数: 0

Abstract

Purpose: Non-adherence to inhaled medication poses a significant clinical and economic burden on patients with respiratory diseases. This narrative review provides an overview of key aspects of hair analysis, in general and specific for inhaled medications, and explores the potential of hair analysis as a novel tool to monitor adherence to inhaled medications.

Methods: PubMed searches were conducted to explore four aspects: (1) mechanisms of (inhaled) drug's systemic absorption and deposition in hair; (2) quantification of drugs in hair; (3) factors impacting (inhaled) drug hair concentrations; and (4) clinical studies assessing inhaled medication adherence through hair analysis.

Results: Systemic absorption, deposition, quantification, and interpretation of drug concentrations in hair are complex phenomena and are influenced by various factors. Analysing drug concentrations in hair segments provides insights into adherence variability over up to 3 months. While studies suggest effective incorporation of several inhaled drugs into hair, inter-individual variability is influenced by external (e.g. UV-exposure), drug- (e.g. lipophilicity) and patient-specific (e.g. hair colour) factors, not just by adherence. The impact of these confounding factors on absolute hair concentrations is still unclear. Intra-individual variability unrelated to adherence appears, however, minimal.

Conclusion: Although hair analysis shows promise as a novel objective bioanalytical method for assessing long-term inhaled medication adherence, until further analytical refinement, clinical validation and a clearer understanding of confounding factors, it should not be relied upon as the sole measure of adherence.

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毛发分析用于监测吸入呼吸药物依从性：可能性和局限性。

目的：不依从吸入药物给呼吸系统疾病患者带来了重大的临床和经济负担。这篇叙述性综述提供了头发分析的关键方面的概述，一般和特定于吸入性药物，并探讨了头发分析作为监测吸入性药物依从性的新工具的潜力。方法：通过PubMed检索，从四个方面探讨：(1)药物（吸入）在毛发中的全身吸收和沉积机制；(2)头发中药物的定量分析；(3)影响（吸入）药发浓度的因素；(4)通过毛发分析评估吸入药物依从性的临床研究。结果：毛发中药物浓度的全身吸收、沉积、定量和解释是一个复杂的现象，受多种因素的影响。分析头发片段中的药物浓度可以洞察长达3个月的依从性变化。虽然研究表明，几种吸入药物有效地融入头发，但个体间的差异受到外部因素（如紫外线暴露）、药物（如亲脂性）和患者特异性因素（如发色）的影响，而不仅仅是依从性。这些混杂因素对头发绝对浓度的影响尚不清楚。然而，与依从性无关的个体内部变异性似乎很小。结论：尽管毛发分析有望成为一种新的客观生物分析方法来评估长期吸入药物依从性，但在进一步的分析完善、临床验证和对混杂因素的更清晰理解之前，不应将其作为依从性的唯一衡量标准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.