title: Saliva and serum levetiracetam concentrations in patients with epilepsy.
abstract: Although antiepileptic drug (AED) monitoring in saliva may have some clinical applicability, it has not yet come into routine use. The correlation between levetiracetam (LEV) saliva and serum concentrations also remains unclear. To confirm LEV saliva assay as a useful, noninvasive alternative to serum measurement, we investigated the possible correlation between saliva and serum LEV concentrations. Samples of saliva and blood were collected from 30 patients with epilepsy receiving chronic therapy with LEV as monotherapy or add-on therapy, and LEV concentrations were assayed in saliva and serum. Linear regression analyses showed a close correlation between saliva and serum LEV concentrations (r2 = 0.90; P < 0.001). LEV blood and saliva concentrations were linearly related to daily drug doses (r2 = 0.78 and 0.70; P < 0.01). When data were analyzed for subgroups (patients receiving LEV in monotherapy, as add-on therapy with enzyme-inducer AEDs, and as add-on therapy with noninducer or moderate-inducer AEDs), no significant difference was found between saliva and serum LEV concentrations among groups. These preliminary results indicate that LEV, like other AEDs, can be measured in saliva as an alternative to blood-based assays. Saliva LEV collection and assay is a valid noninvasive, more convenient alternative to serum measurement.
authors.affiliation: Department of Neurological Sciences, (Neurophysiopathology), La Sapienza University, National Institute of Health, Rome, Italy. oriano.mecarelli@uniroma1.it
authors.forename: Oriano
authors.initials: O
authors.lastname: Mecarelli
authors.forename: Pietro
authors.initials: P
authors.lastname: Li Voti
authors.forename: Stefano
authors.initials: S
authors.lastname: Pro
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Romolo
authors.forename: Maria
authors.initials: M
authors.lastname: Rotolo
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pulitano
authors.forename: Neri
authors.initials: N
authors.lastname: Accornero
authors.forename: Nicola
authors.initials: N
authors.lastname: Vanacore
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000097:blood / Q000378:metabolism / Q000627:therapeutic use*; D016903:Drug Monitoring / Q000379:methods*; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010889:Piracetam / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism / Q000627:therapeutic use; D012463:Saliva / Q000737:chemistry*
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam