Assessment of the Use of Point-Of-Care Pregabalin Testing For Drug Monitoring, Compared to Gas Chromatography Mass- Spectrometry – A Pilot Study

Hamad Al Ghafri, Abuelgasim El

Abstract

Pregabalin is a structural derivative of the inhibitory neurotransmitter Gammaaminobutyric Acid (GABA) and is used in the treatment of anxiety disorder, neuropathic pain and as an anti-convulsant. The prescription of pregabalin has increased in recent years along with reports of its abuse (especially through taking high doses). Consequently, there is a need to monitor the use of pregabalin in patients prescribed the drug as well as those potentially using it without prescription. Point-of-care testing has been used for many years in monitoring illicit drug use but has only become available recently for pregabalin. In order to validate the effectiveness of this approach, a point-of-care testing device for pregabalin was compared with ‘gold standard’ gas chromatography with mass-spectrometry. The results of a pilot study involving 300 patient urine samples showed that the point-of-care pregabalin testing device was appropriate for determining instances where pregabalin had not been used, but due to the observation of 4% false positives, mass-spectrometry confirmation is recommended (as is usually the case for immunoassay-based approaches, especially in a medico-legal context).