ArticleClinical pharmacology and therapeutics2020
MTXPK.org: A Clinical Decision Support Tool Evaluating High-Dose Methotrexate Pharmacokinetics to Inform Post-Infusion Care and Use of Glucarpidase.
Article in Clinical pharmacology and therapeutics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05899751 (High-dose Methotrexate Patterns of Use, Clearance, Toxicities, Supportive Care and Outcomes), which is not on this map. Cited by 45 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
High-dose Methotrexate Patterns of Use, Clearance, Toxicities, Supportive Care and Outcomes
Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Population pharmacokinetic analyses of methotrexate in pediatric patients: a systematic review.European journal of clinical pharmacology · 2024Pooled it
- Factors influencing methotrexate pharmacokinetics highlight the need for individualized dose adjustment: a systematic review.European journal of clinical pharmacology · 2024Pooled it
- Extracorporeal Treatment for Methotrexate Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup.Clinical journal of the American Society of Nephrology : CJASN · 2022Pooled it
- Response to the correspondence by Saba Mushtaq et al. regarding "Development and validation of high-dose methotrexate population pharmacokinetic models to inform clinical decisions on dosing".European journal of clinical pharmacology · 2026Article
- Successful re-exposure to high-dose methotrexate after severely delayed methotrexate elimination and renal toxicity in children with acute lymphoblastic leukemia.Haematologica · 2026Article
- A Model-Informed Early Prediction of Methotrexate-Induced Acute Kidney Injury in Pediatric Patients with Osteosarcoma Using Real-World Data: A Multi-center Pharmacokinetic Study.Clinical pharmacokinetics · 2026Article
- Development and validation of high-dose methotrexate population pharmacokinetic models to inform clinical decisions on dosing.European journal of clinical pharmacology · 2026Article
- Clinical Model-Informed Precision Dosing Consult Service for Accelerating Personalized Medication in Pediatric Patients.Clinical pharmacology and therapeutics · 2026Review
- High-dose methotrexate toxicokinetic variability persists despite standardized 24-hour infusion in childhood ALL.Cancer chemotherapy and pharmacology · 2026Article
- Article
- Effective high-dose methotrexate toxicity reversal using fixed-dose glucarpidase in obese patients: a case series.Journal of medical case reports · 2026Review
- Use of a Cystatin C-Based GFR Equation in a Population Pharmacokinetic Model of Methotrexate Clearance in Adult Patients with Lymphoma.Clinical pharmacokinetics · 2026Article
- Pharmacokinetics as a Biomarker.Clinical and translational science · 2026Article
- Strategies for Managing Toxicities With High-Dose Methotrexate in Haematological Malignancies: Lessons From Clinical Cases.Clinical case reports · 2026Article
- Article
- High-Dose Methotrexate at All Ages: Safety, Efficacy, and Outcomes from the HDMTX European Registry.Cancers · 2025Article
- The Coming of Age of Model-Informed Precision Therapeutics for Children.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Dosing chemotherapy in children with obesity: literature review and evaluation of local practices.Cancer chemotherapy and pharmacology · 2025Review
- Prevention and Treatment of Acute Kidney Injury Associated with High-Dose Methotrexate.Kidney360 · 2025Review
- Consensus on managing delayed methotrexate elimination in high-dose therapy: insights from the Middle East.Frontiers in oncology · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Methotrexate (MTX), an antifolate, is administered at high doses to treat malignancies in children and adults. However, there is considerable interpatient variability in clearance of high-dose (HD) MTX. Patients with delayed clearance are at an increased risk for severe nephrotoxicity and life-threatening systemic MTX exposure. Glucarpidase is a rescue agent for severe MTX toxicity that reduces plasma MTX levels via hydrolysis of MTX into inactive metabolites, but is only indicated when MTX concentrations are > 2 SDs above the mean excretion curve specific for the given dose together with a significant creatinine increase (> 50%). Appropriate administration of glucarpidase is challenging due to the ambiguity in the labeled indication. A recent consensus guideline was published with an algorithm to provide clarity in when to administer glucarpidase, yet clinical interpretation of laboratory results that do not directly correspond to the algorithm prove to be a limitation of its use. The goal of our study was to develop a clinical decision support tool to optimize the administration of glucarpidase for patients receiving HD MTX. Here, we describe the development of a novel 3-compartment MTX population pharmacokinetic (PK) model using 31,672 MTX plasma concentrations from 772 pediatric patients receiving HD MTX for the treatment of acute lymphoblastic leukemia and its integration into the online clinical decision support tool, MTXPK.org. This web-based tool has the functionality to utilize individualized demographics, serum creatinine, and real-time drug concentrations to predict the elimination profile and facilitate model-informed administration of glucarpidase.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.