{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:11:50Z","timestamp":1787847110842,"version":"build-2784847793"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      The aim of the study is to provide insight into the real\u2010world use of therapeutic drug monitoring (\n                      <jats:styled-content style=\"fixed-case\">TDM<\/jats:styled-content>\n                      ) for the most common antiseizure medications (\n                      <jats:styled-content style=\"fixed-case\">ASMs<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In total, 137\u2009586 samples from the period 2019\u20132023 were collected from the five main Danish laboratories performing TDM. A previously described algorithm developed to exclude abnormal TDM results from patient data was applied. This resulted in the inclusion of 84\u2009951 samples from 53\u2009406 patients. Concentration ranges were calculated as 10th to 90th percentiles for the datasets of the ASMs: brivaracetam, carbamazepine, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, phenobarbital, topiramate, valproic acid, and zonisamide. The observed concentration ranges were compared to the established reference ranges from Danish laboratories, the International League Against Epilepsy (ILAE), and the Arbeitsgemeinschaft f\u00fcr Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP). Furthermore, data were stratified based on sex, age groups (0\u201317, 18\u201364, and 65\u2013100\u2009years) and indication (all indications vs psychiatric indication).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The observed concentration ranges showed good overall concordance with reference ranges from Danish laboratories except for levetiracetam, whereas the ranges for brivaracetam, lacosamide, lamotrigine, levetiracetam, valproic acid, and zonisamide were different from the AGNP and ILAE guidelines. Age\u2010related differences were identified for several of the drugs. The calculated range of lamotrigine was lower in samples requested from psychiatric departments compared to samples from non\u2010psychiatric departments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The applied automated approach can facilitate a fast and efficient method for comparing established reference ranges with nationwide TDM datasets, thereby allowing continual monitoring of laboratory reference ranges. The findings from this study suggest that the Danish reference range for levetiracetam should be reevaluated. Furthermore, dose adjustment may be relevant for levetiracetam, topiramate, and lacosamide to account for age\u2010related changes in metabolism. The lower concentration range for lamotrigine in the psychiatric population indicates that it may be effective at lower concentrations in patients with bipolar disorder compared to patients with epilepsy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.18330","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T11:00:34Z","timestamp":1741777234000},"page":"1888-1898","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of antiseizure medication concentration ranges in blood samples using an automated big data approach"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9975-6216","authenticated-orcid":false,"given":"Mariam","family":"Nersesjan","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology Copenhagen University Hospital \u2013 Bispebjerg and Frederiksberg  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"Hoffmann\u2010L\u00fccke","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Greibe","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per Hersom","family":"Aaslo","sequence":"additional","affiliation":[{"name":"The Laboratory of the Danish Epilepsy Centre\u2013Filadelfia  Dianalund Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasse Kristoffer","family":"Bak","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Copenhagen University Hospital \u2013 Rigshospitalet  Glostrup Denmark"},{"name":"Translational Research Center (TRACE) Copenhagen University Hospital \u2013 Rigshospitalet  Glostrup Denmark"},{"name":"Department of Drug Design and Pharmacology University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars Engers","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry N\u00e6stved, Slagelse and Ringsted Hospitals  Slagelse Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palle Bach Nielsen","family":"Fruekilde","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anette","family":"Stark","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Copenhagen University Hospital \u2013 Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Neurology Copenhagen University Hospital \u2013 Bispebjerg and Frederiksberg  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9385-6435","authenticated-orcid":false,"given":"Jakob","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Neurology Aarhus University Hospital, Affiliated Member of Epi\u2010CARE  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Br\u00f8nden","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Copenhagen University Hospital \u2013 Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3462-5849","authenticated-orcid":false,"given":"Jens Borggaard","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Holb\u00e6k Hospital  Holb\u00e6k Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2008.01561.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-017-0363-z"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1258\/acb.2008.008170"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1939-165X.2009.00179.x"},{"issue":"2","key":"e_1_2_11_6_1","first-page":"47","article-title":"Quality, origins and limitations of common therapeutic drug reference intervals","volume":"5","author":"McCudden 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