In vitro Removal of Therapeutic Drugs with a Novel Adsorbent System

Background/Aim: Substances in the middle molecular weight range
have been shown to play a significant pathogenetic role in as
diverse disorders as end-stage renal disease and multiple organ
failure. To overcome the limitations in the amount removed by
hemofilters, new sorbents with a high biocompatibility are actively
being developed. Furthermore, biocompatible sorbents by their
nonspecific adsorptive behavior could have great impact on
detoxification treatment in exogenous intoxications. We performed
an in vitro evaluation of a newly developed highly biocompatible
sorbent cartridge (Betasorb(R)), examining its adsorptive capacity
concerning therapeutic drugs. Methods: Uremic blood spiked with a
range of therapeutic drugs was recirculated for 2 h in an in vitro
hemoperfusion circuit containing a Betasorb device for
hemoperfusion. The drug concentrations before and after the passage
of the cartridge were measured, and the total amount removed was
calculated. Results: The sorbent showed effective removal of
glycopeptide antibiotics, digoxin, theophylline, phenobarbital,
phenytoin, carbamazepine, and valproic acid. Moderate removal could
be demonstrated for tacrolimus and cyclosporine A; aminoglycosides
were removed to a small extent only. Conclusions: Betasorb
hemoperfusion shows a potent adsorptive capacity concerning
therapeutic drugs (except aminoglycosides) and could be of major
value in the treatment of intoxications. On the other hand, drug
monitoring and possible adjustments are necessary during Betasorb
hemoperfusion to maintain the therapeutic ranges of the drugs in
blood. Copyright (C) 2002 S. Karger AG, Basel.