SynthesisClinical journal of the American Society of Nephrology : CJASN2022
Extracorporeal Treatment for Methotrexate Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup.
Synthesis in Clinical journal of the American Society of Nephrology : CJASN, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 11 citations in OpenAlex.
- Toxidromes.Nature reviews. Disease primers · 2026Review
- Delayed methotrexate toxicity after initial clearance in a critically ill patient with severe fluid overload.BMC pediatrics · 2026Article
- Article
- Severe Methotrexate toxicity after ectopic pregnancy: a case report managed with continuous renal replacement therapy.Cancer chemotherapy and pharmacology · 2026Article
- Extracorporeal management of severe methotrexate toxicity and acute kidney injury in the absence of glucarpidase.BMJ case reports · 2025Article
- Beyond the budget impact model: A case study for glucarpidase and the real cost of managing curable toxicities.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2025Article
- Article
- Navigating methotrexate toxicity: Examining the therapeutic roles of folinic acid and glucarpidase.British journal of clinical 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
- High-flux hemodialysis as rescue therapy for high-dose methotrexate toxicity: case series and clinical insights.Frontiers in medicine · 2025Review
- Case Report: Effective methotrexate removal by combined hemodialysis and polymeric resin hemoadsorption.Frontiers in nephrology · 2025Article
- A European consensus recommendation on the management of delayed methotrexate elimination: supportive measures, leucovorin rescue and glucarpidase treatment.Journal of cancer research and clinical oncology · 2024Review
- Serum Methotrexate Level Predicts Acute Kidney Injury After High-Dose Methotrexate: A Case Report and Single-Center Experience.International journal of nephrology and renovascular disease · 2024Article
- Role of molecular adsorbent recirculating system in methotrexate-induced acute liver failure: a case report and literature review.Frontiers in pediatrics · 2024Article
- Precision nephrotoxicity testing using 3D in vitro models.Cell & bioscience · 2023Review
- Glucarpidase for Treating Adults with Delayed Methotrexate Elimination Due to Impaired Renal Function: An Economic Simulation Analysis.ClinicoEconomics and outcomes research : CEOR · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 9 institutions in 6 countries.
Funding
Abstract
Methotrexate is used in the treatment of many malignancies, rheumatological diseases, and inflammatory bowel disease. Toxicity from use is associated with severe morbidity and mortality. Rescue treatments include intravenous hydration, folinic acid, and, in some centers, glucarpidase. We conducted systematic reviews of the literature following published EXtracorporeal TReatments In Poisoning (EXTRIP) methods to determine the utility of extracorporeal treatments in the management of methotrexate toxicity. The quality of the evidence and the strength of recommendations (either "strong" or "weak/conditional") were graded according to the GRADE approach. A formal voting process using a modified Delphi method assessed the level of agreement between panelists on the final recommendations. A total of 92 articles met inclusion criteria. Toxicokinetic data were available on 90 patients (89 with impaired kidney function). Methotrexate was considered to be moderately dialyzable by intermittent hemodialysis. Data were available for clinical analysis on 109 patients (high-dose methotrexate [>0.5 g/m
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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.