Reference Chemistry Laboratory at St Thomas'

Laboratory overview

Opening hours: Monday to Friday, 9am - 5:30pm

We are a UKAS accredited medical laboratory (No.9093), accredited to ISO15189:2012 for the tests listed in the schedule of accreditation available on the UKAS website (https://www.ukas.com/wp-content/uploads/schedule_uploads/00007/9093-Medical-Single.pdf). Any tests not currently accredited, are noted as such in the test details on this website.

We provide fast and efficient services to local Haemato-Oncology teams within the South East London Cancer Network. We play a crucial role in the urgent referral process for newly diagnosed myeloma patients from primary care to specialist care.

Our test repertoire covers specialised testing in Immunochemistry (proteins), Endocrinology and Cardiovascular Markers.

Our users include local and external Haemato-oncology teams, Gastroenterology, Dermatology and Rheumatology teams, Endocrinology teams and other external laboratories.

Key features

We are the first UK centre to provide anti-TNF alpha drug monitoring
We undertake collaborative research into anti-TNF alpha drug monitoring in Gastroenterology and Dermatology
We are one of few centres in the UK to provide cholinesterase phenotyping complemented by genotyping
We have a broad repertoire of cardiovascular markers

Last updated on 19/01/2021

view our tests

Tuesday, 30 June, 2015

Utility of Measuring Infliximab Drug Levels and Anti-Drug Antibodies in Clinical Practice: A Large IBD Referral Centre Experience

The development of infliximab (IFX) drug level and anti-drug antibody (ADA) testing has allowed a personalised approach to IFX use in inflammatory bowel disease (IBD). We present our 2-year experience at a tertiary IBD centre.

EL Johnston , BD Warner , JL Digby-Bell , Nick Unsworth , S Anderson , JD Sanderson , Zehra Arkir , PM Irving

Tuesday, 30 June, 2015

Measurement of TNF-Alpha Drug Levels and Free Versus Total Anti-Drug Antibodies Using Three Commercially Available Assays

Commercial assays are now available for therapeutic drug monitoring (TDM) of anti-TNF drugs and antibodies (ADAb). Utility of free versus total ADAb assays remains debatable, further complicated by lack of assay standardisation. Here we report analytical comparison of 3 commercially available assays for Infliximab (IFX) and Adalimumab (ADAL) drug levels (DL) and ADAb.

Zehra Arkir , Nick Unsworth , BD Warner , Gill Richards , PM Irving

Tuesday, 30 June, 2015

Laboratory Experience of Anti-TNF Drug Monitoring in Routine Practice - Perspective From the First UK Centre

Therapeutic drug monitoring (TDM) of Infliximab (IFX) and Adalimumab (ADAL) has been in use in our centre since 2012. Here we present the TDM experience of our laboratory service at Viapath, St Thomas’ Hospital.

Zehra Arkir , Nick Unsworth , Gill Richards , Zain Odho , PM Irving

Tuesday, 30 June, 2015

Utility of Measuring Adalimumab Drug Levels and Anti-Drug Antibodies in Clinical Practice: A Large IBD Referral Centre Experience

The development of adalimumab (Ada) drug and antibody testing has allowed a personalised approach to complex inflammatory bowel disease (IBD) treatment. We present our 2-year experience at a tertiary IBD referral centre.

BD Warner , EL Johnston , JL Digby-Bell , Nick Unsworth , S Anderson , JD Sanderson , Zehra Arkir , PM Irving

Tuesday, 30 June, 2015

Selective Monitoring of Anti-TNF Drug Levels and Antibodies Will Reduce Short-Term Prescribing Costs and Provide Early Personalised Tailoring of Anti-TNF Therapy in Routine IBD Practice

Clinical trial results suggest that measurement of antiTNF drug levels (ATL) and antibodies (ATA) may have a cost-saving as well as clinically beneficial effect in patients with IBD. We aimed to assess whether selective monitoring of ATL and ATA reduces prescribing costs and how it affects clinical decisions in ordinary clinical practice.

TA Tandiari , A Ibarra , L Younge , A Palma Allepuz , A Thompson , U Meade , Zehra Arkir , E Giles , L Langmead , JO Lindsay , G Parkes , D Rampton

Monday, 8 June, 2015

Utility of Measuring Free vs. Total Anti-Infliximab Antibodies in Assessing Clinical Response to Infliximab in Patients With Inflammatory Bowel Disease

Therapeutic drug monitoring (TDM) of Infliximab (IFX) has been in use in our centre since 2012 and has become increasingly widespread in the UK with the availability of several CE marked assays. TDM of IFX is useful in optimisation of therapy in patients with inflammatory bowel disease (IBD). The detection of antibodies against Infliximab can guide clinical decision making with regard to dose escalation, immunomodulation or drug switching / withdrawal. However the utility of measuring free versus total (IFX-complex + free) anti-Infliximab antibody (ADAb) remains debatable, further complicated by lack of assay standardisation.

Nick Unsworth , MG Ward , PM Irving , BD Warner , Zehra Arkir

Wednesday, 25 February, 2015

Association Between Inflammatory Bowel Disease Activity and Therapeutic Drug Monitoring of Azathioprine and Infliximab Comparing Free and Total Antidrug Antibody Measurement

Therapeutic drug monitoring (TDM) of infliximab (IFX) is useful in patients with inflammatory bowel disease (IBD). Therapeutic cut-offs to predict active disease and the influence of thiopurines on drug levels (DL) according to 6-thioguanine nucleotide (TGN) are not defined. There is limited data on the utility of free anti-drug antibodies (ADAb) against total ADAb. We assessed the utility of TDM of IFX in IBD using a commercially available ELISA and investigated the influence of TGNs on DL and free/total ADAb.

M Ward , B Warner , Nick Unsworth , J Sanderson , Zehra Arkir , P Irving

Wednesday, 25 February, 2015

A Prospective Evaluation of Adalimumab Drug Levels and Anti-Drug Antibodies Using Two Commercial ELISA and the Influence of 6-Thioguanine Nucleotides Amongst Patients With Crohn's Disease

Some, but not all, studies have demonstrated a relationship between therapeutic drug monitoring (TDM) of adalimumab (ADA) and outcomes in Crohn's disease (CD). We evaluated the utility of TDM of ADA in patients with CD using two commercially-available ELISA.

M Ward , B Warner , SW Chuah , S Shieh , Nick Unsworth , J Sanderson , M Parkes , Zehra Arkir , P Irving

Monday, 28 October, 2013

Clinical utility of measuring adalimumab trough levels and antibodies to adalimumab in patients with inflammatory bowel diseases

MG Ward , VC Kariyawasam , SB Mogan , PA Blaker , KP Patel , M Pantelidou , S Anderson , JD Sanderson , Nick Unsworth , Zehra Arkir , PM Irving

Tuesday, 13 August, 2013

Predicting treatment response in psoriasis using serum levels of adalimumab and etanercept: a single-centre, cohort study

A substantial proportion of patients with psoriasis do not respond or lose initial response to tumour necrosis factor antagonists.

S.K. Mahil , Zehra Arkir , G. Richards , C.M. Lewis , J.N. Barker , C.H. Smith

Thursday, 27 June, 2013

Measurement of infliximab and anti-infliximab antibodies - analytical aspects and clinical implications

Commercial assays for monitoring Infliximab (IFX) and anti-drug antibodies (ADAb) are currently available.

Nick Unsworth , Zehra Arkir , P. Irving , M.G.Ward , G. Richards

Wednesday, 27 February, 2013

Prediction of treatment response in psoriasis with measurement of serum levels of adalimumab, etanercept, and antidrug antibodies: a pilot study

A substantial proportion of patients with psoriasis do not respond or lose initial response to tumour necrosis factor antagonists.

Dr SK Mahil , Zehra Arkir , G Richards , JN Barker , CH Smith

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Zehra Arkir

Principal Clinical Scientist

Malinie Naidoo

Reference Services Quality Manager