An FDA-approved medication called glucarpidase could serve as an antidote to kidney toxicity in patients receiving the chemotherapy drug methotrexate (MTX), according to a new study by investigators at Mass General Brigham.
Mass General BrighamJan 6 2025 An FDA-approved medication called glucarpidase could serve as an antidote to kidney toxicity in patients receiving the chemotherapy drug methotrexate , according to a new study by investigators at Mass General Brigham. Using data from 28 major U.S. cancer centers, the researchers examined the association between glucarpidase treatment – which rapidly clears MTX from the blood – and outcomes of patients with MTX-induced acute kidney injury .
Due to its ability to penetrate the blood-brain barrier, MTX is one of the most common chemotherapeutic agents used worldwide for cancers involving the central nervous system. However, high doses of MTX often cause severe complications such as AKI, liver toxicity, and neutropenia . Glucarpidase converts MTX in the blood into inactive metabolites within 15 minutes of its administration.
Target trial emulation is a way to effectively analyze real-world data and to draw causal inferences from it, especially when clinical trials are unavailable and would be impractical to perform. We worked with dozens of our collaborators across 28 sites to extract granular data from medical records – all by manual chart review – which allowed us to account for key variables in our models. This allowed us to have a high degree of confidence in our findings.
The authors evaluated data collected between 2000 and 2022 from 708 patients with MTX-induced AKI, including 209 who received glucarpidase within four days following MTX exposure and 499 who did not. They compared kidney recovery for the two groups at the time of hospital discharge, based on changes in serum creatinine levels. The investigators also examined the speed of kidney recovery as well as the incidence of other adverse events, such as liver toxicity and neutropenia.
Chemotherapy Kidney Acute Kidney Injury Blood Brain Cancer Central Nervous System Clinical Trial Healthcare Hospital Liver Medicine Methotrexate Nervous System Neutropenia Research Therapeutics
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