Is methotrexate nephrotoxic? : Dose-dependency, comorbidities and comedication.
Summary of "Is methotrexate nephrotoxic? : Dose-dependency, comorbidities and comedication."
Methotrexate (MTX) in low-doses is an important component of anti-inflammatory therapy of rheumatoid arthritis and other inflammatory joint diseases. In contrast to high-dose administration of MTX in oncology, which can lead to direct tubulus toxicity and subsequent renal failure, renal side-effects are a rare exception for low-dose MTX. The biggest problem under low-dose MTX is that an already limited renal function due to comorbidities or an increasing, sometimes clinically insufficiently monitored renal insufficiency due to comedications, such as non-steroidal antirheumatics (NSAR) and antibiotics, leads to a reduced excretion of MTX and therefore to an accumulation in serum. This is primarily accompanied by gastrointestinal mucositis and bone marrow depression. For this reason low-dose MTX should never be administered once the glomerular filtration rate (GFR) is less than <30 ml/min and only 50% of the original dosage should be administered if the GFR is between 30 and 60 ml/min.
Division of Nephrology, University of Virginia Health System, 800133, 22908, Charlottesville, USA, firstname.lastname@example.org.
This article was published in the following journal.
Name: Zeitschrift fur Rheumatologie
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21735288
- DOI: http://dx.doi.org/10.1007/s00393-011-0830-6
Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy...
Palmoplantar pustular psoriasis is a debilitating chronic disease that can have a serious impact on patients' quality of life. There currently is no therapeutics standard for controlling palmoplantar ...
Background : Systemic therapy with methotrexate is a very useful modality in psoriasis, but relapses can occur soon after stopping it. Aim : To compare the relapse rates in psoriasis with two differen...
Dexamethasone prolongs the duration of single-shot interscalene brachial plexus block (SISB). However, dose-dependency of dexamethasone as an adjuvant for SISB remains insufficiently understood.
To evaluate the benefits of the addition of leflunomide (LEF) in children with polyarticular course juvenile idiopathic arthritis (JIA), non-responsive to standard dose parenteral methotrexate (MTX).
Giving both the gap existing between the current recommendations to prevent/detect comorbidities and the clinical practice in patients suffering from spondyloarthritis and also the specifi...
The purpose of this study is to investigate the clinical efficacy of high-dose methotrexate consolidation therapy for adult patients with BCR-ABL-negative ALL.
The purpose of this study is to determine the effective dose of BMS-945429 in subjects with inadequate response to Methotrexate in the treatment of moderate to severe Rheumatoid Arthritis.
RATIONALE: Drugs used in chemotherapy, such as methotrexate, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. PURPO...
The purpose of this clinical study is to compare the efficacy and safety of three concentrations of topical methotrexate for the treatment of fingernail psoriasis.
Medical and Biotech [MESH] Definitions
The dose amount of poisonous or toxic substance or dose of ionizing radiation required to kill 50% of the tested population.
The highest dose of a biologically active agent given during a chronic study that will not reduce longevity from effects other than carcinogenicity. (from Lewis Dictionary of Toxicology, 1st ed)
Administration of the total dose of radiation (RADIATION DOSAGE) in parts, at timed intervals.
Radiotherapy where there is improved dose homogeneity within the tumor and reduced dosage to uninvolved structures. The precise shaping of dose distribution is achieved via the use of computer-controlled multileaf collimators.
A specific immune response elicited by a specific dose of an immunologically active substance or cell in an organism, tissue, or cell.