Research & Literature

Genetic Determinants of Methotrexate Toxicity in Tunisian Patients with Rheumatoid Arthritis: A Study of Polymorphisms Involved in the MTX Metabolic Pathway.

Chaabane S, Marzouk S, Akrout R, et al.

European journal of drug metabolism and pharmacokinetics 2016; (41(4)):385-93 doi:10.1007/s13318-015-0288-z.

Functional variants of gene encoding folate metabolizing enzyme and methotrexate-related toxicity in children with acute lymphoblastic leukemia.

Kałużna E, Strauss E, Zając-Spychała O, et al.

European journal of pharmacology 2015; (769()):93-9.

Delayed elimination of high-dose methotrexate and use of carboxypeptidase G2 in pediatric patients during treatment for acute lymphoblastic leukemia.

Svahn T, Mellgren K, Harila-Saari A, et al.

Pediatric blood & cancer 2017; (64(7)) doi:10.1002/pbc.26395.

Association Between MTHFR C677T Polymorphism and Methotrexate Treatment Outcome in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis.

Shao W, Yuan Y, Li Y

Genetic testing and molecular biomarkers 2017; (21(5)):275-285 doi:10.1089/gtmb.2016.0326.

Low-dose methotrexate-induced acute interstitial pneumonitis: Report of two cases from South India and review of literature.

Iyyadurai R, Carey RA, Satyendra S

Journal of family medicine and primary care 2016; (5(4)):875-878 doi:10.4103/2249-4863.201163.

Inhibition of Methotrexate Uptake via Organic Anion Transporters OAT1 and OAT3 by Glucuronides of Nonsteroidal Anti-inflammatory Drugs.

Iwaki M, Shimada H, Irino Y, et al.

Biological & pharmaceutical bulletin 2017; (40(6)):926-931 doi:10.1248/bpb.b16-00970.

Consensus Guideline for Use of Glucarpidase in Patients with High-Dose Methotrexate Induced Acute Kidney Injury and Delayed Methotrexate Clearance.

Ramsey LB, Balis FM, O'Brien MM, et al.

The oncologist 2018; (23(1)):52-61 doi:10.1634/theoncologist.2017-0243.

Does daily folic acid supplementation reduce methotrexate efficacy?

Cline A, Jorizzo JL

Dermatology online journal 2017; (23(11)).

Improving the safety of high-dose methotrexate for children with hematologic cancers in settings without access to MTX levels using extended hydration and additional leucovorin.

Vaishnavi K, Bansal D, Trehan A, et al.

Pediatric blood & cancer 2018; (65(12)):e27241 doi:10.1002/pbc.27241.

Severe bone marrow suppression due to methotrexate toxicity following aceclofenac-induced acute kidney injury.

Manappallil RG, Prasan D, Peringat J, Biju IK

BMJ case reports 2018; (2018()) doi:10.1136/bcr-2018-224722.

The effect of intravenous hydration strategy on plasma methotrexate clearance during intravenous high-dose methotrexate administration in pediatric oncology patients.

Traivaree C, Likasitthananon N, Monsereenusorn C, Rujkijyanont P

Cancer management and research 2018; (10()):4471-4478 doi:10.2147/CMAR.S172117.

[Methotrexate induced crystalline nephropathy: A rare histological finding on renal biopsy].

Colpart P, Félix S

Annales de pathologie 2019; (39(1)):18-23 doi:10.1016/j.annpat.2018.08.005.

Renal clearance and intracellular half-life essentially determine methotrexate toxicity: A case series.

Arakawa Y, Arakawa A, Vural S, et al.

JAAD case reports 2019; (5(1)):98-100 doi:10.1016/j.jdcr.2018.10.022.

Changes in intracellular folate metabolism during high-dose methotrexate and Leucovorin rescue therapy in children with acute lymphoblastic leukemia.

Oosterom N, de Jonge R, Smith DEC, et al.

PloS one 2019; (14(9)):e0221591 doi:10.1371/journal.pone.0221591.

Investigation on inhibitory effect of folic acid on methotrexate-induced epithelial-mesenchymal transition focusing on dihydrofolate reductase.

Kawami M, Honda N, Hara T, et al.

Drug metabolism and pharmacokinetics 2019; (34(6)):396-399 doi:10.1016/j.dmpk.2019.08.003.

DAMPAned Methotrexate: A Case Report and Review of the Management of Acute Methotrexate Toxicity.

Young A, Beriault D, Jung B, et al.

Canadian journal of kidney health and disease 2019; (6()):2054358119895078 doi:10.1177/2054358119895078.

Effect of proton pump inhibitors on high-dose methotrexate elimination: a systematic review and meta-analysis.

Wang X, Song Y, Wang J, et al.

International journal of clinical pharmacy 2020; (42(1)):23-30 doi:10.1007/s11096-019-00958-5.

Evaluation of methotrexate clearance with an enteral urine alkalinization protocol for patients receiving high-dose methotrexate.

Kramer E, Filtz M, Pace M

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 2021; (27(1)):26-32 doi:10.1177/1078155220908946.

Serum Methotrexate Level and Side Effects of High Dose Methotrexate Infusion in Pediatric Patients with Acute Lymphoblastic Leukaemia (ALL).

Sajith M, Pawar A, Bafna V, et al.

Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion 2020; (36(1)):51-58 doi:10.1007/s12288-019-01144-3.

Methotrexate-Induced Pancytopenia and Mucositis Caused by Medication Error.

Amissah-Arthur MB, Baah W

Ghana medical journal 2020; (54(1)):68-71 doi:10.4314/gmj.v54i1.10.

Systematic review of recommendations on the use of methotrexate in rheumatoid arthritis.

Valerio V, Kwok M, Loewen H, et al.

Clinical rheumatology 2021; (40(4)):1259-1271 doi:10.1007/s10067-020-05363-2.

Significant interaction between high-dose methotrexate and high-dose piperacillin-tazobactam causing reversible neurotoxicity and renal failure in an osteosarcoma patient.

Krämer I, Rosentreter J, Fried M, Kühn M

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 2021; (27(4)):1000-1004 doi:10.1177/1078155220953878.

Risk of haematological events and preventive effect of folic acid in methotrexate users with chronic kidney disease and rheumatoid arthritis: Analysis of the Japanese Adverse Drug Event Report database.

Mitsuboshi S

British journal of clinical pharmacology 2021; (87(5)):2286-2289 doi:10.1111/bcp.14641.

The case of methotrexate and the lung: Dr Jekyll and Mr Hyde.

Cottin V, Bendstrup E, Bonniaud P, et al.

The European respiratory journal 2021; (57(2)) doi:10.1183/13993003.00079-2021.

DNA Double-Strand Breaks Affect Chromosomal Rearrangements during Methotrexate-Mediated Gene Amplification in Chinese Hamster Ovary Cells.

Baik JY, Han HJ, Lee KH

Pharmaceutics 2021; (13(3)) doi:10.3390/pharmaceutics13030376.

Histone H3 lysine-trimethylation markers are decreased by recombinant methioninase and increased by methotrexate at concentrations which inhibit methionine-addicted osteosarcoma cell proliferation.

Aoki Y, Tome Y, Han Q, et al.

Biochemistry and biophysics reports 2021; (28()):101177 doi:10.1016/j.bbrep.2021.101177.

Evidence-Based Criteria Supporting Early Discharge for Pediatric Patients With Osteosarcoma Receiving High-Dose Methotrexate: A Retrospective Chart Review.

Armideo E, Froio S, Johnson M, et al.

Journal of the advanced practitioner in oncology 2022; (13(2)):143-149 doi:10.6004/jadpro.2022.13.2.5.

Hypoalbuminemia and not undernutrition predicts high-dose methotrexate-induced nephrotoxicity in children with acute lymphoblastic leukemia in resource-constrained centers.

Khera S, Sharma G, Negi V, Shaw SC

Pediatric blood & cancer 2022; (69(9)):e29738 doi:10.1002/pbc.29738.

Prevalence and management of methotrexate-induced neurotoxicity in pediatric patients with osteosarcoma: a single-center experience.

Peled Y, Levin D, Shiran S, et al.

International journal of clinical oncology 2022; (27(8)):1372-1378 doi:10.1007/s10147-022-02184-y.

Crystalline Nephropathy With High-Dose Methotrexate in a Patient With Primary CNS Lymphoma: A Case Report.

Sami FL, Hammo H, Athavale A

Cureus 2022; (14(6)):e26052 doi:10.7759/cureus.26052.

Subacute methotrexate neurotoxicity in patients with oncohematological disease. A report of 3 cases.

Delgado EF, Ruggeri RA, Calvo C

Archivos argentinos de pediatria 2023; (121(2)):e202202649 doi:10.5546/aap.2022-02649.eng.

Hypoplastic Myelodysplastic Syndrome: Symptom of Methotrexate Toxicity in Rheumatoid Arthritis.

Khan A, Anwar M, Azam A, et al.

Cureus 2023; (15(6)):e40580 doi:10.7759/cureus.40580.

Comment on: A pooled subgroup analysis of glucarpidase treatment in 86 pediatric, adolescent, and young adult patients receiving high-dose methotrexate therapy in open-label trials.

Meyers PA

Pediatric blood & cancer 2023; (70(11)):e30617 doi:10.1002/pbc.30617.

Low-dose methotrexate toxicity leading to pancytopenia: leucovorin as a rescue treatment.

Schelzel G, Palicherla A, Tauseef A, Millner P

Proceedings (Baylor University. Medical Center) 2024; (37(2)):339-343 doi:10.1080/08998280.2023.2289299.

A Rare Case of Acute Methotrexate Toxicity Leading to Bone Marrow Suppression.

Khuwaja S, Lyons M, Zulfiqar B

Case reports in rheumatology 2024; (2024()):7693602 doi:10.1155/2024/7693602.

From Treatment to Tragedy: Severe Methotrexate Toxicity With Mucocutaneous Ulcers, Myelosuppression, and Nephropathy.

Sawant R, Chaudhari P, Bardiya NA, et al.

Cureus 2024; (16(4)):e57797 doi:10.7759/cureus.57797.

Older age, CNS leukaemic involvement and induction tumour lysis increases the risk of methotrexate (MTX)-induced neurotoxicity in childhood acute lymphoblastic leukaemia/lymphoma: Experience from a tertiary care centre in South India.

Rupakumar T, Sankar A, Vijayasekharan K, et al.

British journal of haematology 2024; (205(1)):220-228 doi:10.1111/bjh.19559.

Navigating methotrexate toxicity: Examining the therapeutic roles of folinic acid and glucarpidase.

Chan BS, Bosco AA, Buckley NA

British journal of clinical pharmacology 2025; (91(3)):628-635 doi:10.1111/bcp.16096.

Single Low-Dose Methotrexate and Vitamin B12 Deficiency-Induced Pancytopenia Causing Fatality: A Case Report.

Akhdar G, Akpan I, Myles A, Atencah SE

Cureus 2024; (16(6)):e63528 doi:10.7759/cureus.63528.

Role of molecular adsorbent recirculating system in methotrexate-induced acute liver failure: a case report and literature review.

Corbisier T, Von Bueren AO, Breunis WB, Grazioli S

Frontiers in pediatrics 2024; (12()):1424919 doi:10.3389/fped.2024.1424919.

Serum Methotrexate Level Predicts Acute Kidney Injury After High-Dose Methotrexate: A Case Report and Single-Center Experience.

Yen PW, Lin HY, Wu CC, et al.

International journal of nephrology and renovascular disease 2024; (17()):277-285 doi:10.2147/IJNRD.S487368.

Accidental methotrexate overdose leading to multisystem toxicity: A case report.

Asaduzzaman M, Karim MR, Saha P, et al.

Toxicology reports 2024; (13()):101821 doi:10.1016/j.toxrep.2024.101821.

High-flux hemodialysis as rescue therapy for high-dose methotrexate toxicity: case series and clinical insights.

Tome ACN, Santos KF, Lima EQ, Ramalho RJ

Frontiers in medicine 2025; (12()):1495705 doi:10.3389/fmed.2025.1495705.

Identifying risk factors for methotrexate-induced acute kidney injury despite full prevention in patients with primary central nervous system lymphoma.

Lin WY, Tsai CK, Yeh CM, Liu CJ

Toxicology and applied pharmacology 2025; (502()):117436 doi:10.1016/j.taap.2025.117436.

Mucocutaneous Adverse Effects of Methotrexate Toxicity: A Case Series.

Subedi B, Bhandari S, Timilsina S, et al.

JNMA; journal of the Nepal Medical Association 2025; (63(283)):189-194 doi:10.31729/jnma.8905.

A Clinical Case of Methotrexate Toxicity.

Peixoto AC, de Almeida Mota R, Rodrigues ALM, et al.

Journal of medical cases 2025; (16(8)):314-317 doi:10.14740/jmc5159.

Analytical Validation of a Second-Generation Methotrexate Immunoassay.

Wilson R, Yamaguchi D, Garrett J, et al.

The journal of applied laboratory medicine 2026; (11(1)):73-82 doi:10.1093/jalm/jfaf166.

Consensus on managing delayed methotrexate elimination in high-dose therapy: insights from the Middle East.

Al Manasour M, Absi A, Alhuraiji A, et al.

Frontiers in oncology 2025; (15()):1660937 doi:10.3389/fonc.2025.1660937.

[Methotrexate osteopathy-a critical review].

Braun J, Buehring B

Zeitschrift fur Rheumatologie 2026; (85(3)):240-246 doi:10.1007/s00393-025-01755-4.

Severe Methotrexate toxicity after ectopic pregnancy: a case report managed with continuous renal replacement therapy.

Chao Y, Liu Q, Li A, Zhang Y

Cancer chemotherapy and pharmacology 2026; (96(1)).