Drug updated on 12/11/2024
| Dosage Form | Injection (intravenous; 1,000 units/vial) |
| Drug Class | Carboxypeptidases |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated for the treatment of toxic plasma methotrexate concentrations (>1 micromole per liter) in adult and pediatric patients with delayed methotrexate clearance (plasma methotrexate concentrations greater than 2 standard deviations of the mean methotrexate excretion curve specific for the dose of methotrexate administered) due to impaired renal function.
Latest News
Summary
- This summary is based on the review of one systematic review/meta-analysis. [1]
- In an observational study, patients treated with glucarpidase exhibited a lower mortality rate compared to those treated with hemodialysis, although significant limitations in the study were acknowledged.
- Among the analyzed population of 109 patients with impaired kidney function, mortality rates were 19.5% for those receiving high-dose methotrexate (n=91) and 26.7% for those receiving low-dose methotrexate (n=18).
- No explicit data on the safety profile or adverse effects of glucarpidase were provided in the study, and no safety comparisons with hemodialysis or other treatments were mentioned.
- There is no safety information available in the reviewed studies.
- In patients with impaired kidney function, glucarpidase treatment was associated with an overall mortality rate of 19.5% for high-dose methotrexate-related toxicity (91 patients) and 26.7% for low-dose methotrexate-related toxicity (18 patients), indicating the need to consider treatment efficacy and mortality risk in these specific subgroups.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Voraxaze (glucarpidase) Prescribing Information. | 2019 | BTG International Inc., Philadelphia, PA |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| Extracorporeal Treatment for Methotrexate Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup | 2022 | Clinical Journal of the American Society of Nephrology |
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| A European consensus recommendation on the management of delayed methotrexate elimination: supportive measures, leucovorin rescue and glucarpidase treatment | 2024 | Journal of Cancer Research and Clinical Oncology |
| Incidence and management of patients with methotrexate delayed elimination in the clinical practice: A Delphi study. | 2023 | Journal of Oncology Pharmacy Practice |