Abstract:
:In January 2012, glucarpidase (Voraxaze(®)) received approval from the US Food and Drug Administration for intravenous treatment of toxic plasma methotrexate concentrations due to impaired renal clearance. Methotrexate, an antifolate agent, has been used for over 60 years in the treatment of various cancers. High-dose methotrexate has been particularly useful in the treatment of leukemias and lymphomas. However, even with aggressive hydration and urine alkalinization, such regimens can lead to acute renal dysfunction, as indicated by decreases in urine production and concomitant increases in blood urea nitrogen and serum creatinine levels. Because methotrexate is largely excreted by the kidneys, this can greatly potentiate tissue damage. Toxic levels of blood methotrexate can be rapidly and effectively decreased by intravenous administration of glucarpidase. Glucarpidase is a recombinant form of carboxypeptidase G2, a bacterial enzyme that rapidly cleaves methotrexate to form the amino acid glutamate and 2,4-diamino-N(10)-methylpteroic acid. Catabolites of methotrexate are much less toxic than the parent compound, and are primarily excreted by hepatic mechanisms. Glucarpidase has been available on a compassionate basis since the 1990s, and a variety of case reports and larger clinical trials have demonstrated the safety and efficacy of this drug in patients ranging in age from infants to the elderly and in a variety of races and ethnic groups. Glucarpidase should not be administered within 2 hours of leucovorin, because this agent is a reduced folate which competes with methotrexate for the enzyme and glucarpidase inactivates leucovorin. Side effects of glucarpidase are rare and relatively mild, and include paraesthesia, flushing, nausea, vomiting, pruritus, and headache. Glucarpidase has seen limited use in intrathecal treatment of methotrexate toxicity for which it is also effective. Future applications of this enzyme in chemotherapy continue to be an active area of research.
journal_name
Ther Clin Risk Managjournal_title
Therapeutics and clinical risk managementauthors
Green JMdoi
10.2147/TCRM.S30135subject
Has Abstractpub_date
2012-01-01 00:00:00pages
403-13eissn
1176-6336issn
1178-203Xpii
tcrm-8-403journal_volume
8pub_type
杂志文章abstract:INTRODUCTION:Renal cell carcinoma (RCC) represents 2%-3% of all cancers in adults, and its pathogenesis is mainly related to altered cellular response to hypoxia. Lenvatinib, a novel multitarget tyrosine kinase inhibitor (TKI), represents a therapeutic option, in combination with mammalian target of rapamycin (mTOR) in...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S126910
更新日期:2017-06-30 00:00:00
abstract:BACKGROUND:Internationally, there is a remarkable achievement in the areas of drug discovery, drug design, and clinical trials. New and efficient drug formulation techniques are widely available which have led to success in treatment of several diseases. Despite these achievements, large number of patients continue to ...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S85019
更新日期:2015-06-30 00:00:00
abstract::Treatment of advanced, recurrent or persistent cervical cancer includes radiotherapy and chemotherapy. Radiation has been the primary treatment modality for locoregionally advanced cervical cancer. Concomitant systemic cisplatin chemotherapy and radiation have shown high response rates with improvements in durable rem...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.s1771
更新日期:2008-02-01 00:00:00
abstract::Treatment of HIV-1 infection has produced dramatic success for many patients. Nevertheless, viral resistance continues to limit the efficacy of currently available agents in many patients. The CCR5 antagonists are a new class of antiretroviral agents that target a necessary coreceptor for viral entry of many strains o...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.s1997
更新日期:2008-04-01 00:00:00
abstract:Purpose:We aimed to build a model to qualitatively and quantitatively evaluate publications of research of spinal cord injury rehabilitation from 1997 to 2016. Methods:Data were obtained from the Web of Science Core Collection on October 6, 2017. We conducted a qualitative and quantitative analysis of publication outp...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S163881
更新日期:2018-12-17 00:00:00
abstract::Procarbazine HCl is a 'nonclassical' oral alkylating anticancer agent that was first synthesized in the late 1950s. It has been used in the treatment of many cancers, but its main use is in the treatment of Hodgkin's lymphoma and brain tumors and, to a lesser extent, Non-Hodgkin's lymphoma and primary central nervous ...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.2007.3.2.213
更新日期:2007-06-01 00:00:00
abstract:INTRODUCTION:The seven-year experience of elective abdominal aortic aneurysm (AAA) repair of a vascular surgical unit in a teaching hospital was reviewed to determine the factors associated with in-hospital mortality. METHODS:All patients who underwent elective open repair of an AAA between July 1, 1991, and June 30, ...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.1.1.27.53602
更新日期:2005-03-01 00:00:00
abstract::Antimicrobial agents are the most valuable means available for treating bacterial infections. However, the administration of therapeutic doses of antimicrobial agents to patients is a leading cause of disturbance of the normal gastrointestinal microflora. This disturbance results in diminishing the natural defense mec...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.s4328
更新日期:2008-12-01 00:00:00
abstract::Some specific features of the 24 h blood pressure (BP) pattern are linked to the progressive injury of target tissues and the triggering of cardiac and cerebrovascular events. In particular, many studies show the extent of the nocturnal BP decline relative to the diurnal BP mean (the diurnal/nocturnal ratio, an index ...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.2007.3.1.119
更新日期:2007-03-01 00:00:00
abstract::Chronic rhinosinusitis (CRS) is a chronic disease that affects 14.2% of the US adult population. Despite being widespread, little is known about the etiology of CRS. Treatment has been symptomatic and focused on relieving symptoms. Recent investigations into causes of CRS have revealed that most CRS patients have an e...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.2007.3.2.319
更新日期:2007-06-01 00:00:00
abstract:Purpose:Almost all of the publications regarding the treatment of biliary complications after liver transplantation are related to biliary complications after right lobe living donor liver transplantation (LDLT) and cadaveric liver transplantation (LT). The number of publications regarding endoscopic treatment of bilia...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S175215
更新日期:2018-10-17 00:00:00
abstract::Hyperphosphatemia is an inevitable consequence of end stage chronic kidney disease and is present in the majority of dialysis patients. Recent observational data has associated hyperphosphatemia with increased cardiovascular mortality among dialysis patients. Dietary restriction of phosphate and current dialysis presc...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.s1555
更新日期:2008-10-01 00:00:00
abstract::Sodium disorders are the most common and most poorly understood electrolyte disorders in neurological patients. The aim of this study was to determine the incidence of sodium disorders and its association with different traumatic brain injuries. This prospective study was conducted in 80 patients diagnosed with modera...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S17692
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:This study aims to investigate differences between continuous epidural infusion (CEI) and programmed intermittent epidural bolus (IEB) analgesia for the Chinese parturients undergoing spontaneous delivery and to approach their safety to parturients and neonates. METHODS:Two hundred healthy American Society ...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S106021
更新日期:2016-07-14 00:00:00
abstract:Purpose:Videolaryngoscopy in nasotracheal intubation has been reported to be better than direct laryngoscopy. The most suitable type of videolaryngoscope remains unknown. This study aimed to compare two videolaryngoscopes (McGrath MAC and Pentax AWS) with a Macintosh laryngoscope during nasotracheal intubation. Method...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S220451
更新日期:2019-09-18 00:00:00
abstract:BACKGROUND:This retrospective cohort study evaluated whether manual lymphatic drainage (MLD) therapy increases the risk of recurrence of breast cancer. METHODS:We analyzed 1,106 women who were diagnosed with stage 0-3 breast cancer between 2007 and 2011 and experienced remission after surgery and adjuvant therapy. The...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S79118
更新日期:2015-02-27 00:00:00
abstract::The antiresorptive drug elcatonin (ECT) is known to relieve pain in postmenopausal women with osteoporosis. A prospective open-labeled trial was conducted to compare the effects of short-term combined treatment with alendronate (ALN) and ECT on bone mineral density (BMD) and bone turnover with those of single treatmen...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.s5982
更新日期:2009-06-01 00:00:00
abstract:Background:Hydroxychloroquine (HCQ), one of the disease-modifying antirheumatic drugs, may lead to an inhibition of autophagy. Autophagy, an intracellular self-defense mechanism for the lysosomal degradation of cytoplasmic components such as damaged organelles, plays a role in protecting against neoplasm growth but is ...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S175581
更新日期:2018-08-20 00:00:00
abstract::Angiogenesis is an essential process in the development, growth, and metastasis of malignant tumors including lung cancer. Several angiogenesis inhibitors have been developed as potential therapies for non-small-cell lung cancer (NSCLC). Nintedanib is a small-molecule tyrosine kinase inhibitor that targets receptors f...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S76646
更新日期:2015-11-16 00:00:00
abstract::A 9-year-old girl was severely injured in a car accident in Afghanistan, in which both her lower legs were badly damaged. She was treated at the Hospital of Ingolstadt (Klinikum Ingolstadt) after she had undergone initial surgery at an Indian hospital. Various bacterial species were isolated from multiple wounds, and ...
journal_title:Therapeutics and clinical risk management
pub_type:
doi:10.2147/TCRM.S99987
更新日期:2016-05-11 00:00:00
abstract:BACKGROUND/PURPOSE:In-hospital mortality rate of acute ischemic stroke patients remains between 3% and 18%. For improving the quality of stroke care, we investigated the factors that contribute to the risk of in-hospital mortality in acute ischemic stroke patients. MATERIALS AND METHODS:Between January 1, 2007, and De...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S105703
更新日期:2016-06-29 00:00:00
abstract::East Asians are prone to higher systemic exposure and increased risk of bleeding compared to other races after administration of antiplatelet agent(s). The aim of this systematic review was to compare and evaluate the appropriateness of a lower dose versus standard dose of ticagrelor in East Asians. A systematic searc...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S152276
更新日期:2018-01-08 00:00:00
abstract::Over recent decades, basic research has yielded a large volume of data on many potentially clinically relevant genetic determinants of drug efficacy and toxicity. Until recently, most examples involved genes encoding drug-metabolizing enzymes, particularly the cytochromes P450. More recently, rapid advances in genomic...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:
更新日期:2007-10-01 00:00:00
abstract::This study examined the associations of diabetes-related distress (DRD), depressive symptoms, health-related quality of life (HRQoL), and medication adherence with glycemia, blood pressure (BP), and lipid biomarkers in adults with type 2 diabetes mellitus (T2D). This cross-sectional study was conducted in three Malays...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S81623
更新日期:2015-04-29 00:00:00
abstract::Objective: Intraventricular hemorrhage (IVH) is characterized by acute onset, rapid progression, and high disability and mortality rates. In this study, we investigated the clinical effect of external ventricular drainage combined with continuous lumbar drainage in IVH treatments. Methods: 114 patients with IVH treate...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S207750
更新日期:2019-05-30 00:00:00
abstract::Allergic rhinitis and urticaria are common allergic diseases that may have a major negative impact on patients' quality of life. Bilastine, a novel new-generation antihistamine that is highly selective for the H1 histamine receptor, has a rapid onset and prolonged duration of action. This agent does not interact with ...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
doi:10.2147/TCRM.S105189
更新日期:2016-04-13 00:00:00
abstract::Recovery after total hip arthroplasty (THA) is influenced by several psychological aspects, such as depression, anxiety, resilience, and personality traits. We hypothesized that preoperative depression impedes early functional outcome after THA (primary outcome measure). Additional objectives were perioperative change...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S127868
更新日期:2017-02-21 00:00:00
abstract::The application of anthracyclines in anticancer therapy may result in accidental extravasation injury and can be a serious complication of their use. Tissue necrosis with skin ulceration is a possible outcome in the inadvertent extravasation of anthracyclines during intravenous administration. Until recently, there ha...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.s3694
更新日期:2009-04-01 00:00:00
abstract::The myelodysplastic syndromes (MDS) are a heterogeneous group of disorders that manifest as bone marrow failure with the risk of life threatening infections and bleeding. A third of these patients may transform to acute leukemia. Age and co-morbidities have limited treatment in the majority to supportive care with a m...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.2006.2.4.377
更新日期:2006-12-01 00:00:00
abstract:Background:Hyperparathyroidism is a frequent endocrine disorder with variable clinical manifestations and outcomes. We aimed to evaluate clinical presentations, management and outcomes of hyperparathyroidism. Methods:A retrospective study was conducted to include all patients presented with hyperparathyroidism between...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S160896
更新日期:2018-07-31 00:00:00