Delayed methotrexate clearance despite carboxypeptidase-G2 (Glucarpidase) administration in 2 patients with toxic methotrexate levels

Kirk Wyatt; Jeffrey Cooper; Katherine Scott; Eileen Broomall; Sadaf Altaf; Marie C. Hogan; Vilmarie Rodriguez; Shakila Khan

Delayed methotrexate clearance despite carboxypeptidase-G2 (Glucarpidase) administration in 2 patients with toxic methotrexate levels

Kirk Wyatt
, Jeffrey Cooper
, Katherine Scott
, Eileen Broomall
, Sadaf Altaf
, Marie C. Hogan
, Vilmarie Rodriguez
, Shakila Khan

Department of Oncology, Medical College, Pakistan

Research output: Contribution to journal › Article

Abstract

High-dose methotrexate has been a treatment for osteosarcoma; however, its nephrotoxic effects are considerable. Carboxypeptidase-G2 (glucarpidase) was approved by the US Food and Drug Administration in 2012 for treatment of toxic methotrexate levels. We report our experience using glucarpidase under compassionate use before Food and Drug Administration approval in 2 patients who had delayed methotrexate clearance and prolonged kidney injury despite glucarpidase administration. Our results show that patients with methotrexate toxicity may require repeated doses of glucarpidase in addition to supportive measures, such as dialysis.

Original language	Undefined/Unknown
Journal	Department of Radiation Oncology
Publication status	Published - 1 Mar 2018

Access to Document

http://ecommons.aku.edu/pakistan_fhs_mc_radiat_oncol/72

Cite this

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title = "Delayed methotrexate clearance despite carboxypeptidase-G2 (Glucarpidase) administration in 2 patients with toxic methotrexate levels",

abstract = "High-dose methotrexate has been a treatment for osteosarcoma; however, its nephrotoxic effects are considerable. Carboxypeptidase-G2 (glucarpidase) was approved by the US Food and Drug Administration in 2012 for treatment of toxic methotrexate levels. We report our experience using glucarpidase under compassionate use before Food and Drug Administration approval in 2 patients who had delayed methotrexate clearance and prolonged kidney injury despite glucarpidase administration. Our results show that patients with methotrexate toxicity may require repeated doses of glucarpidase in addition to supportive measures, such as dialysis.",

author = "Kirk Wyatt and Jeffrey Cooper and Katherine Scott and Eileen Broomall and Sadaf Altaf and Hogan, \{Marie C.\} and Vilmarie Rodriguez and Shakila Khan",

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T1 - Delayed methotrexate clearance despite carboxypeptidase-G2 (Glucarpidase) administration in 2 patients with toxic methotrexate levels

AU - Wyatt, Kirk

AU - Cooper, Jeffrey

AU - Scott, Katherine

AU - Broomall, Eileen

AU - Altaf, Sadaf

AU - Hogan, Marie C.

AU - Rodriguez, Vilmarie

AU - Khan, Shakila

PY - 2018/3/1

Y1 - 2018/3/1

N2 - High-dose methotrexate has been a treatment for osteosarcoma; however, its nephrotoxic effects are considerable. Carboxypeptidase-G2 (glucarpidase) was approved by the US Food and Drug Administration in 2012 for treatment of toxic methotrexate levels. We report our experience using glucarpidase under compassionate use before Food and Drug Administration approval in 2 patients who had delayed methotrexate clearance and prolonged kidney injury despite glucarpidase administration. Our results show that patients with methotrexate toxicity may require repeated doses of glucarpidase in addition to supportive measures, such as dialysis.

AB - High-dose methotrexate has been a treatment for osteosarcoma; however, its nephrotoxic effects are considerable. Carboxypeptidase-G2 (glucarpidase) was approved by the US Food and Drug Administration in 2012 for treatment of toxic methotrexate levels. We report our experience using glucarpidase under compassionate use before Food and Drug Administration approval in 2 patients who had delayed methotrexate clearance and prolonged kidney injury despite glucarpidase administration. Our results show that patients with methotrexate toxicity may require repeated doses of glucarpidase in addition to supportive measures, such as dialysis.

M3 - Article

JO - Department of Radiation Oncology

JF - Department of Radiation Oncology

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