Comparison of an HPLC-UV system (LM1010) and UPLC-MS/MS for plasma voriconazole measurement in routine clinical practice

Background We aimed to evaluate the clinical utility of the LM1010 high-performance liquid chromatography with ultraviolet-visible detection instrument for measuring plasma concentrations of voriconazole (VRCZ) under routine clinical conditions, including in patients with diverse clinical backgrounds. Methods In total, 213 samples were collected from two hospitals (groups A and B). The plasma samples were analyzed using LM1010 and ultra performance liquid chromatography (UPLC)-tandem mass spectrometry (MS/MS). Laboratory test values and information on concomitant medications were collected from electronic medical records. Results In total, 66 samples from group A and 135 samples from group B were included in the analysis. VRCZ plasma concentrations measured by LM1010 and UPLC-MS/MS were strongly correlated in both groups ( r  = 0.983 and 0.996; both P  < 0.001). The Bland-Altman analysis demonstrated proportional bias in both groups A and B, and the slopes of the regression lines were 0.045 (95% confidence interval [CI], 0.011–0.079) and 0.038 (95% CI, 0.025–0.052), respectively. Interfering peaks were observed in the chromatograms of eight samples in group B, but their effect on the intermethod difference was small. No clinical laboratory test values or concomitant medications were identified as factors affecting the intermethod difference. Conclusions The measurement of VRCZ plasma concentration by LM1010 was robust under heterogeneous clinical conditions and was useful for clinical therapeutic drug monitoring of VRCZ.