Key result
CytoSorb and Porapak Q 50-80 mesh sorbents removed 99% of edoxaban from human plasma and bovine serum albumin solutions, decreasing average concentrations from 407 ng/mL to 3.3 ng/mL.
Why the study?
Based on prior experience with sorbent-mediated removal of ticagrelor, dabigatran, and radiocontrast agents, the study evaluated two sorbents for the removal of edoxaban.
Does sorbent-mediated technology reduce edoxaban concentration in human plasma and albumin solution in vitro?
Does sorbent-mediated technology reduce edoxaban concentration in human plasma and albumin solution in vitro?
Effect estimate: 99% removal
Absolute Event Rate: 3.3% vs 407%
p-value: p=0.017
Sorbent-mediated technology using CytoSorb or Porapak Q effectively removes edoxaban from human plasma and albumin solutions in vitro, suggesting a potential pathway for drug reversal.
Supports sorbent exploration for edoxaban reversal; leaves open in vivo efficacy and clinical translation.
BACKGROUND AND OBJECTIVE: Based on previous experience of sorbent-mediated ticagrelor, dabigatran, and radiocontrast agent removal, we set out in this study to test the effect of two sorbents on the removal of edoxaban, a factor Xa antagonist direct oral anticoagulant. METHODS: We circulated 100 mL of edoxaban solution during six first-pass cycles through 40-mL sorbent columns (containing either CytoSorb in three passes or Porapak Q 50-80 mesh in the remaining three passes) during experiments using human plasma and 4% bovine serum albumin solution as drug vehicles. Drug concentration was measured by liquid chromatography-tandem mass spectrometry. RESULTS: Edoxaban concentration in two experiments performed with human plasma dropped from 276.8 to 2.7 ng/mL and undetectable concentrations, respectively, with CytoSorb or Porapak Q 50-80 mesh (p = 0.0031). The average edoxaban concentration decreased from 407 ng/mL ± 216 ng/mL to 3.3 ng/mL ± 7 ng/mL (p = 0.017), for a removal rate of 99% across all six samples of human plasma (two samples) and bovine serum albumin solution (four samples). In four out of the six adsorbed samples, the drug concentrations were undetectable. CONCLUSION: Sorbent-mediated technology may represent a viable pathway for edoxaban removal from human plasma or albumin solution.
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Angheloiu et al. (2020) studied In-vitro edoxaban removal (n=6). CytoSorb or Porapak Q 50-80 mesh sorbents vs. Baseline concentration was evaluated on Edoxaban concentration (99% removal, p=0.017). CytoSorb and Porapak Q 50-80 mesh sorbents removed 99% of edoxaban from human plasma and bovine serum albumin solutions, decreasing average concentrations from 407 ng/mL to 3.3 ng/mL.
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