Historique
Article de Périodique
Enhancing addiction care: Benefits of urinary screening with LC-HRMS (liquid chromatography-high resolution mass spectrometry) for psychoactive substances and drugs (2025)
Auteur(s) :
LE CARPENTIER, E. ;
HELESBEUX, M. ;
BIERING, V. ;
AQUIZERATE, A. ;
ROUSSELET, M. ;
BARRANGOU-POUEYS-DARLAS, M. ;
VERHOLLEMAN, A. ;
DAILLY, E. ;
GREGOIRE, M. ;
VICTORRI-VIGNEAU, C. ;
DUVAL, M.
Année
2025
Page(s) :
art. 111465
Langue(s) :
Anglais
Domaine :
Autres substances / Other substances ; Drogues illicites / Illicit drugs
Discipline :
PRO (Produits, mode d'action, méthode de dépistage / Substances, action mode, screening methods)
Thésaurus géographique
FRANCE
Thésaurus mots-clés
ANALYSE CHIMIQUE
;
DEPISTAGE
;
URINE
;
METHODE
;
ETUDE CLINIQUE
;
TOXICOLOGIE
;
PRODUIT ILLICITE
;
MEDICAMENTS
;
PSYCHOTROPES
;
HOSPITALISATION
;
BENEFICE
Résumé :
Introduction: Immunoassay (IA) is currently used at Nantes University Hospital to perform urine drug screening in the inpatient addiction unit. Given its numerous limitations, we aimed to assess the overall benefit of the Liquid-Chromatography-High-Resolution-Mass Spectrometry (LC-HRMS), and to identify the profiles of patients for whom its use provided a clinical benefit.
Methods: All adult patients admitted to this unit between January and September 2023 were systematically included. A part of the urine sample routinely collected on admission was retained for subsequent analysis by LC-HRMS. For each active molecule, the analytical performance of LC-HRMS compared with IA was evaluated by biologists. Then unit's physicians assessed for each patient whether the new data provided by LC-HRMS would have had an impact on their management. A multivariate analysis was carried out to identify the profiles of these patients.
Results: 154 patients were included with 293 non-prescribed molecules and 434 prescribed drugs. For 2/3 of all molecules, LC-HRMS performed better than IA. Most of these molecules were not detectable by IA but some were not detected even though they belonged to the panel of detectable substances. Physicians considered that the new results provided by LC-HRMS would have had an impact on the management of 1/4 of patients. A history of opiate abuse/dependence was associated with a clinical benefit of LC-HRMS in the multivariate analysis.
Conclusion: These results confirm the benefit of LC-HRMS for urine drug screening in inpatient addiction units for patients with multiple substance use, especially those with a history of opioid use. [Author's abstract]
Highlights:
LC-HRMS is a sensitive specific drug screening method of interest in addiction units.
LC-HRMS covers a wide range of substances including new psychoactive substances (NPS).
Toxicological screening by LC-HRMS has higher analytical performance than immunoassay.
In this study LC-HRMS results were considered clinically relevant for 1/4 of patients.
LC-HRMS is particularly useful for patients with a history of opioid use.
Methods: All adult patients admitted to this unit between January and September 2023 were systematically included. A part of the urine sample routinely collected on admission was retained for subsequent analysis by LC-HRMS. For each active molecule, the analytical performance of LC-HRMS compared with IA was evaluated by biologists. Then unit's physicians assessed for each patient whether the new data provided by LC-HRMS would have had an impact on their management. A multivariate analysis was carried out to identify the profiles of these patients.
Results: 154 patients were included with 293 non-prescribed molecules and 434 prescribed drugs. For 2/3 of all molecules, LC-HRMS performed better than IA. Most of these molecules were not detectable by IA but some were not detected even though they belonged to the panel of detectable substances. Physicians considered that the new results provided by LC-HRMS would have had an impact on the management of 1/4 of patients. A history of opiate abuse/dependence was associated with a clinical benefit of LC-HRMS in the multivariate analysis.
Conclusion: These results confirm the benefit of LC-HRMS for urine drug screening in inpatient addiction units for patients with multiple substance use, especially those with a history of opioid use. [Author's abstract]
Highlights:
LC-HRMS is a sensitive specific drug screening method of interest in addiction units.
LC-HRMS covers a wide range of substances including new psychoactive substances (NPS).
Toxicological screening by LC-HRMS has higher analytical performance than immunoassay.
In this study LC-HRMS results were considered clinically relevant for 1/4 of patients.
LC-HRMS is particularly useful for patients with a history of opioid use.
Affiliation :
Nantes Université, CHU Nantes, Service de Pharmacologie Clinique, Nantes, France