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Establishment of a measurement system to evaluate breast milk transfer of biological agents using dry filter paper: a multi-institutional study
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  • Jumpei Saito,
  • Naho Yakuwa,
  • Yoshihiko Hosokawa,
  • Hiromi Hamada,
  • Tomo Suzuki,
  • Haruhiko Sago,
  • Kayoko Kaneko,
  • Akimasa Yamatani,
  • Atsuko Murashima
Jumpei Saito
National Center for Child Health and Development

Corresponding Author:saito-jn@ncchd.go.jp

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Naho Yakuwa
National Center for Child Health and Development
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Yoshihiko Hosokawa
University of Tsukuba Hospital
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Hiromi Hamada
University of Tsukuba Hospital
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Tomo Suzuki
National Center for Child Health and Development
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Haruhiko Sago
National Center for Child Health and Development
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Kayoko Kaneko
National Center for Child Health and Development
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Akimasa Yamatani
National Center for Child Health and Development
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Atsuko Murashima
National Center for Child Health and Development
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Abstract

Aims Information on breastfeeding and the safety of biologics in infants is lacking due to difficulties in case collection. We evaluated a method for determining the concentration of biologics in breast milk using a dry filter method that can simplify the collection, storage, and transport of breast milk. Methods To generate dried filter paper (DFP) samples, approximately 30 L of breast milk was placed onto a Whatman 903 card and punched out. After extraction, the supernatant was measured using an enzyme-linked immunosorbent assay. Three concentrations of each drug were prepared in liquid breast milk (LBM) and DFP samples for stability testing, which confirmed that samples were stable up to 28 days after storage at 2–8 ºC or -20 ºC for LBM and at 25±5 ºC for DFP. LBM and DFP samples were provided by lactating mothers using biologics during lactation. Drug concentrations were compared. Results Breast milk was provided by 12 lactating mothers (tocilizumab, n=4; abatacept, n=2; etanercept, n=1; golimumab, n=1; sarilumab, n=1; and belimumab, n=3). The accuracy and precision of measurements for the six drugs were within acceptable limits. After 28 days, concentrations remained at more than 90% under all storage conditions. The quantitative values of the provided LBM and DFP samples were similar. The maximum relative infant dose ranged from 0.09% to 1.12%, which was an acceptable range. Conclusion A method for determining the concentration of biologics using DFP is expected to help improve pharmacotherapy for lactating women.
25 Apr 2023Submitted to British Journal of Clinical Pharmacology
26 Apr 2023Submission Checks Completed
26 Apr 2023Assigned to Editor
26 Apr 2023Review(s) Completed, Editorial Evaluation Pending
02 May 2023Reviewer(s) Assigned
29 Jun 2023Editorial Decision: Revise Major
09 Jul 20231st Revision Received
10 Jul 2023Submission Checks Completed
10 Jul 2023Assigned to Editor
10 Jul 2023Review(s) Completed, Editorial Evaluation Pending
22 Jul 2023Reviewer(s) Assigned
31 Jul 2023Editorial Decision: Accept