Is anyone running these assays on the Roche analysers in the UK?
Thanks
Ian
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of SPENCER Kevin (RF4) BHR Hospitals
Sent: 03 June 2016 16:42
To: [log in to unmask]
Subject: Re: PlGF based testing to rule out pre-eclampsia
For those wanting some sensible clinical guidance here then a current review of clinical cut offs established primarily with the Roche platform can be found at :-
http://onlinelibrary.wiley.com/doi/10.1002/uog.14799/full
Although the platforms from PE and from Brahms have been specifically excluded from the Guidance from Nice - this is unfortunate in that Nice doesn’t have much input from those that have used these assays in a clinical context. Whilst at the time that Nice were finalising these guidelines very few studies had been published with the Brahms or PE platforms that will change very soon. The group from Harvard (Thandani et al) will publish data showing that the cut offs used for the Roche platform equally apply to the brahms platform and the group from Charite in Berlin (Verlohren et al) will also publish new clinical studies which also show equivalence.
However these tests are expensive and require probably follow up every 2 to 3 days to exclude the need for further intervention.
It probably will not be a request made by primary Care but one in which the Fetal medicine specialists will make the call.
Kevin
Professor Kevin Spencer BSc MSc DSc CSci CBiol CChem EuSpLM FRSB FRSC FRCPath Consultant Biochemist Barking Havering & Redbridge University Hospitals NHS Trust Clinical Biochemistry Department King George Hospital Barley Lane Goodmayes Essex IG3 8YB U.K.
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My routine work days are Wednesday, Thursday & Friday Visiting Professor Kings College London Director of Biochemical Screening Fetal Medicine Foundation, London Honorary Consultant Scientist in Fetal Medicine Guy's and St Thomas' NHS Foundation Trust Honorary Consultant Biochemist Heatherwood & Wexham Park Hospitals NHS Foundation Trust
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-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Reynolds Tim (RJF) BHFT
Sent: 03 June 2016 16:31
To: [log in to unmask]
Subject: Re: PlGF based testing to rule out pre-eclampsia
The CCG's will use the two lines saying that it needs more research to refuse funding until there is more evidence. It took us 7 years to get funduing for BNP - so a bit more time for research won't harm. Therefore, the appropriate thing to do is sit back and wait...
**************************************************************************************
Prof. Tim Reynolds
Consultant Chemical Pathologist / Divisional Medical Director (CH&CSS) / R&D Lead, Burton Hospitals NHS Foundation Trust work tel: 01283 511511 ext 4035 work fax: 01283 593064 work email: [log in to unmask] work URL: www.burtonhospitals.nhs.uk This e-mail, and any files transmitted with it, are confidential and intended solely for the use of the individual to whom it is addressed. If you are not the intended recipient please destroy this message, delete any copies held on your systems, and notify the sender immediately. You should not retain copy or use this e-mail for any purpose, nor disclose all or any part of its content to any other person. If you have received this e-mail in error, please notify me on 01283 511511 Ext 4035
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-----Original Message-----
From: Mohammad Al-Jubouri [mailto:[log in to unmask]]
Sent: 03 June 2016 4:25 PM
To: [log in to unmask]; Reynolds Tim (RJF) BHFT
Subject: Re: PlGF based testing to rule out pre-eclampsia
You missed the first paragraph:
1.1 The Triage PlGF test and the Elecsys immunoassay sFlt‑1/PlGF ratio, used with standard clinical assessment and subsequent clinical follow-up, are recommended to help rule‑out pre‑eclampsia in women presenting with suspected pre‑eclampsia between 20 weeks and 34 weeks plus 6 days of gestation.
When pre‑eclampsia is not ruled‑out using a PlGF‑based test result, the result should not be used to diagnose (rule‑in) pre‑eclampsia (see text box).
Just like using BNP to rule out heart failure.
Mohammad
--------------------------------------------
On Fri, 3/6/16, Reynolds Tim (RJF) BHFT <[log in to unmask]> wrote:
Subject: Re: PlGF based testing to rule out pre-eclampsia
To: [log in to unmask]
Date: Friday, 3 June, 2016, 16:19
It depends how you read
the guidance. The following phrases:
there is currently insufficient evidence to recommend their routine adoption for diagnosing pre‑eclampsia in the NHS
The DELFIA Xpress PlGF 1‑2‑3 test and
BRAHMS sFlt‑1 Kryptor/BRAHMS PlGF plus Kryptor PE ratio are not recommended for routine adoption in the NHS.
Make me think
the guidance is NOT to use the tests.
**************************************************************************************
Prof. Tim Reynolds
Consultant Chemical Pathologist / Divisional Medical Director (CH&CSS) / R&D Lead, Burton Hospitals NHS Foundation Trust work tel: 01283 511511 ext 4035 work fax: 01283 593064 work
email: [log in to unmask]
work URL: www.burtonhospitals.nhs.uk
This e-mail, and any files transmitted with it, are confidential and intended solely for the use of the individual to whom it is addressed. If you are not the intended recipient please destroy this message, delete any copies held on your systems, and notify the sender immediately. You should not retain copy or use this e-mail for any purpose, nor disclose all or any part of its content to any other person. If you have received this e-mail in error, please notify me on 01283 511511 Ext 4035
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-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]]
On Behalf Of Mohammad Al-Jubouri
Sent: 03
June 2016 3:55 PM
To: [log in to unmask]
Subject: PlGF based testing to rule out pre-eclampsia
Dear list
members,
The new NICE DG23
guidance (published May 2016) recommends the implementation of this test to rule out pre-eclampsia:
https://www.nice.org.uk/guidance/dg23/chapter/1-Recommendations
I would like to hear from
clinical biochemists with experience in this test and its application in clinical practice.
Best regards
Mohammad
Dr. M
A Al-Jubouri, MB ChB, MSc, EurClinChem, FRCP Edin, FRCPath Consultant Chemical Pathologist
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