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  • Glucarpidase for the treatment of life-threatening methotrexate overdose

    Author(s)
    Tuffaha, HW
    Al Omar, S
    Griffith University Author(s)
    Tuffaha, Haitham W.
    Year published
    2012
    Metadata
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    Abstract
    High-dose methotrexate (HDMTX) is widely and safely used in oncology, with adequate measures including vigorous hydration, urine alkalinization and leucovorin rescue. Despite these precautions, some patients still develop HDMTX-induced nephrotoxicity, which leads to delayed methotrexate (MTX) clearance and sustained elevated plasma MTX levels, which can significantly increase MTX toxicity. Glucarpidase (carboxypeptidase G2, Voraxaseis a recombinant bacterial enzyme that rapidly hydrolyzes MTX to inactive metabolites, providing an alternate non-renal pathway for MTX elimination in patients with renal dysfunction during HDMTX ...
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    High-dose methotrexate (HDMTX) is widely and safely used in oncology, with adequate measures including vigorous hydration, urine alkalinization and leucovorin rescue. Despite these precautions, some patients still develop HDMTX-induced nephrotoxicity, which leads to delayed methotrexate (MTX) clearance and sustained elevated plasma MTX levels, which can significantly increase MTX toxicity. Glucarpidase (carboxypeptidase G2, Voraxaseis a recombinant bacterial enzyme that rapidly hydrolyzes MTX to inactive metabolites, providing an alternate non-renal pathway for MTX elimination in patients with renal dysfunction during HDMTX treatment. Glucarpidase has recently been approved for the treatment of toxic plasma MTX concentrations in patients with delayed MTX clearance due to impaired renal function. Preclinical and clinical studies demonstrated good safety and efficacy in rapidly reducing elevated MTX levels. Further comparative studies are awaited to confirm the benefit of glucarpidase in terms of toxicity and survival.
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    Journal Title
    Drugs of Today
    Volume
    48
    Issue
    11
    Publisher URI
    http://journals.prous.com/journals/servlet/xmlxsl/pk_journals.xml_summary_pr?p_JournalId=4&p_RefId=1871575&p_IsPs=N
    Subject
    Oncology and carcinogenesis not elsewhere classified
    Pharmacology and pharmaceutical sciences
    Publication URI
    http://hdl.handle.net/10072/53110
    Collection
    • Journal articles

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