Etanercept clearance during an in vitro model of continuous venovenous hemofiltration.
OBJECTIVE
Etanercept is a tumor necrosis factor-alpha antagonist used in inflammation-mediated conditions. Continuous venovenous hemofiltration (CVVH) has also been used in patients with inflammatory conditions. This study evaluated etanercept clearance using an in vitro CVVH model.


METHODS
Etanercept clearance was assessed in vitro in bovine blood at 1-3 mg/l final serum concentration, and urea control at 750 mg/l. CVVH was performed using polyacrylonitrile, polysulfone, and polymethylmethacrylate filters at 3 l/h ultrafiltrate and 200 ml/min blood flow rates. Transmembrane clearance was estimated using sieving coefficient calculations, and adsorptive removal rate was approximated using a mass balance calculation.


RESULTS
Urea sieving coefficient remained constant (1.04 +/- 0.01). Ultrafiltrate etanercept concentrations were undetectable (sieving coefficient < 0.02) and transmembrane and adsorptive clearances were negligible.


CONCLUSIONS
Etanercept is not cleared appreciably by transmembrane or adsorptive mechanisms in CVVH using polyacrylonitrile, polysulfone, or polymethylmethacrylate hemofilters.
Fleming
Geoffrey M
GM
Department of Pediatrics, Division of Critical Care, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University, Nashville, Tenn. 37232-3467, USA. geoffrey.fleming@vanderbilt.edu
Salama
Noha N
NN
Eid
Saada K
SK
Cooke
Kenneth R
KR
Mueller
Bruce A
BA
D000180:Acrylic Resins; D000327:Adsorption; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000493:pharmacokinetics*; D002417:Cattle; D000068800:Etanercept; D006440:Hemofiltration / Q000379:methods*; D007074:Immunoglobulin G / Q000494:pharmacology*; D008567:Membranes, Artificial; D008657:Metabolic Clearance Rate; D008954:Models, Biological; D011108:Polymers; D019904:Polymethyl Methacrylate; D018124:Receptors, Tumor Necrosis Factor; D013450:Sulfones
D000180:Acrylic Resins; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007074:Immunoglobulin G; D008567:Membranes, Artificial; D011108:Polymers; D018124:Receptors, Tumor Necrosis Factor; D013450:Sulfones; C010504:polyacrylonitrile; C017662:polysulfone P 1700; D019904:Polymethyl Methacrylate; D000068800:Etanercept