Delayed Methotrexate Clearance Despite Carboxypeptidase-G2 (Glucarpidase) Administration in 2 Patients with Toxic Methotrexate Levels

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

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 languageEnglish (US)
Pages (from-to)152-155
Number of pages4
JournalJournal of Pediatric Hematology/Oncology
Volume40
Issue number2
DOIs
StatePublished - Jan 1 2018

Fingerprint

gamma-Glutamyl Hydrolase
Poisons
Methotrexate
United States Food and Drug Administration
Compassionate Use Trials
Drug Approval
Osteosarcoma
Dialysis
Kidney
Wounds and Injuries
Therapeutics

Keywords

  • carboxypeptidase G2
  • glucarpidase
  • methotrexate
  • osteosarcoma
  • toxicity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Delayed Methotrexate Clearance Despite Carboxypeptidase-G2 (Glucarpidase) Administration in 2 Patients with Toxic Methotrexate Levels. / Wyatt, Kirk D.; Cooper, Jeffrey; Scott, Katherine; Broomall, Eileen; Altaf, Sadaf; Hogan, Marie C; Rodriguez, Vilmarie; Khan, Shakila.

In: Journal of Pediatric Hematology/Oncology, Vol. 40, No. 2, 01.01.2018, p. 152-155.

Research output: Contribution to journalArticle

Wyatt, Kirk D. ; Cooper, Jeffrey ; Scott, Katherine ; Broomall, Eileen ; Altaf, Sadaf ; Hogan, Marie C ; Rodriguez, Vilmarie ; Khan, Shakila. / Delayed Methotrexate Clearance Despite Carboxypeptidase-G2 (Glucarpidase) Administration in 2 Patients with Toxic Methotrexate Levels. In: Journal of Pediatric Hematology/Oncology. 2018 ; Vol. 40, No. 2. pp. 152-155.
@article{bfe86960e67940e6b8015766a0ca78d0,
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.",
keywords = "carboxypeptidase G2, glucarpidase, methotrexate, osteosarcoma, toxicity",
author = "Wyatt, {Kirk D.} and Jeffrey Cooper and Katherine Scott and Eileen Broomall and Sadaf Altaf and Hogan, {Marie C} and Vilmarie Rodriguez and Shakila Khan",
year = "2018",
month = "1",
day = "1",
doi = "10.1097/MPH.0000000000001058",
language = "English (US)",
volume = "40",
pages = "152--155",
journal = "Journal of Pediatric Hematology/Oncology",
issn = "1077-4114",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Delayed Methotrexate Clearance Despite Carboxypeptidase-G2 (Glucarpidase) Administration in 2 Patients with Toxic Methotrexate Levels

AU - Wyatt, Kirk D.

AU - Cooper, Jeffrey

AU - Scott, Katherine

AU - Broomall, Eileen

AU - Altaf, Sadaf

AU - Hogan, Marie C

AU - Rodriguez, Vilmarie

AU - Khan, Shakila

PY - 2018/1/1

Y1 - 2018/1/1

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.

KW - carboxypeptidase G2

KW - glucarpidase

KW - methotrexate

KW - osteosarcoma

KW - toxicity

UR - http://www.scopus.com/inward/record.url?scp=85044346949&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044346949&partnerID=8YFLogxK

U2 - 10.1097/MPH.0000000000001058

DO - 10.1097/MPH.0000000000001058

M3 - Article

C2 - 29240024

AN - SCOPUS:85044346949

VL - 40

SP - 152

EP - 155

JO - Journal of Pediatric Hematology/Oncology

JF - Journal of Pediatric Hematology/Oncology

SN - 1077-4114

IS - 2

ER -