Hemoadsorption eliminates remdesivir from the circulation : Implications for the treatment of COVID-19

© 2021 The Authors. Pharmacology Research & Perspectives published by British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics and John Wiley & Sons Ltd..

Both antiviral treatment with remdesivir and hemoadsorption using a CytoSorb® adsorption device are applied in the treatment of severe COVID-19. The CytoSorb® adsorber consists of porous polymer beads that adsorb a broad range of molecules, including cytokines but also several therapeutic drugs. In this study, we evaluated whether remdesivir and its main active metabolite GS-441524 would be adsorbed by CytoSorb® . Serum containing remdesivir or GS-441524 was circulated in a custom-made system containing a CytoSorb® device. Concentrations of remdesivir and GS-441524 before and after the adsorber were analyzed by liquid chromatography-tandem mass spectrometry. Measurements of remdesivir in the outgoing tube after the adsorber indicated almost complete removal of remdesivir by the device. In the reservoir, concentration of remdesivir showed an exponential decay and was not longer detectable after 60 mins. GS-441524 showed a similar exponential decay but, unlike remdesivir, it reached an adsorption-desorption equilibrium at ~48 µg/L. Remdesivir and its main active metabolite GS-441524 are rapidly eliminated from the perfusate by the CytoSorb® adsorber device in vitro. This should be considered in patients for whom both therapies are indicated, and simultaneous application should be avoided. In general, plasma levels of therapeutic drugs should be closely monitored under concurrent CytoSorb® therapy.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:9

Enthalten in:

Pharmacology research & perspectives - 9(2021), 2 vom: 07. Apr., Seite e00743

Sprache:

Englisch

Beteiligte Personen:

Biever, Paul [VerfasserIn]
Staudacher, Dawid L [VerfasserIn]
Sommer, Michaela J [VerfasserIn]
Triebel, Hannah [VerfasserIn]
Neukamm, Merja A [VerfasserIn]
Bode, Christoph [VerfasserIn]
Supady, Alexander [VerfasserIn]
Lother, Achim [VerfasserIn]

Links:

Volltext

Themen:

1BQK176DT6
3QKI37EEHE
415SHH325A
Adenosine
Adenosine Monophosphate
Alanine
COVID-19
Cytokine
Furans
GS-441524
Hemoadsorption
Journal Article
K72T3FS567
OF5P57N2ZX
Pyrroles
Remdesivir
SARS-CoV-2
Triazines

Anmerkungen:

Date Completed 25.03.2021

Date Revised 04.12.2021

published: Print

Citation Status MEDLINE

doi:

10.1002/prp2.743

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM32267607X