학술논문

Antithrombotic drug removal from whole blood using Haemoadsorption with a porous polymer bead sorbent
ORIGINAL ARTICLE
Document Type
Report
Source
European Heart Journal: Cardiovascular Pharmacotherapy. December 2022, Vol. 8 Issue 5, p847, 10 p.
Subject
United States
Language
English
ISSN
2055-6837
Abstract
Background Anticoagulant and antiplatelet therapies are widely used for the prevention and treatment of thromboembolic complications in patients with cardiovascular disease (CVD). Use of these agents is increasing due to [...]
Aim To evaluate the ability of the DrugSorb (TM) -AntiThrombotic Removal (ATR) haemoadsorption device utilizing porous polymer bead sorbent technology to remove three commonly used antithrombotic drugs from whole blood. Methods and results We evaluated the removal of apixaban, rivaroxaban, and ticagrelor by the DrugSorb-ATR haemoadsorption device in a benchtop clinical scale model using bovine whole blood. Blood spiked at clinically relevant concentrations of an antithrombotic agent was continuously circulated through a 300-mL DrugSorb-ATR haemoadsorption device at a flow rate of 300 mL/min. Drug concentration was monitored over 6 h to evaluate drug removal. Results were compared with a control circuit without the haemoadsorption device. Removal rates at 30, 60, 120, and 360 minutes were: apixaban: 81.5%, 96.3%, 99.3% >99.8%; rivaroxaban: 80.7%, 95.1%, 98.9%, >99.5%; ticagrelor: 62.5%; 75%, 86.6%, >95% (all P Conclusion DrugSorb-ATR efficiently removes apixaban, rivaroxaban, and ticagrelor in a clinical-scale benchtop recirculation circuit with the bulk of removal occurring in the first 60 minutes. The clinical implications of these findings are currently investigated in patients undergoing on-pump cardiothoracic surgery in two US pivotal trials (ClinicalTrials.gov Identifiers: NCT04976530 and NCT05093504). Keywords Apixaban * Rivaroxaban * Ticagrelor * Haemoadsorption * Extracorporeal * Porous polymer beads