Enhancing the Efficacy and Safety of Methotrexate Treatment: A Focus on Drug Interactions (Review) ; Повышение эффективности и безопасности использования метотрексата: фокус на лекарственные взаимодействия (обзор)

التفاصيل البيبلوغرافية
العنوان:	Enhancing the Efficacy and Safety of Methotrexate Treatment: A Focus on Drug Interactions (Review) ; Повышение эффективности и безопасности использования метотрексата: фокус на лекарственные взаимодействия (обзор)
المؤلفون:	S. A. Doktorova, Yu. Yu. Grabovetskaya, M. Stefanov, V. V. Rafalskiy, С. А. Докторова, Ю. Ю. Грабовецкая, М. Стефанов, В. В. Рафальский
المساهمون:	This research was supported by funds provided to the Immanuel Kant Baltic Federal University through the Russian Federal Academic Leadership Programme “Priority 2030” (project No. 123102600004-1)., Данная работа была поддержана из средств программы стратегического академического лидерства «Приоритет 2030» БФУ им. И. Канта, научный проект № 123102600004-1.
المصدر:	Safety and Risk of Pharmacotherapy; 2024: Online First ; Безопасность и риск фармакотерапии; 2024: Online First ; 2619-1164 ; 2312-7821 ; undefined
بيانات النشر:	Federal State Budgetary Institution ‘Scientific Centre for Expert Evaluation of Medicinal Products’ of the Ministry of Health of the Russian Federation (FSBI ‘SCEEMP’)
سنة النشر:	2024
المجموعة:	Safety and Risk of Pharmacotherapy (E-Journal) / Безопасность и риск фармакотерапии
مصطلحات موضوعية:	нестероидные противовоспалительные препараты, drug interactions, adverse drug reactions, pharmacokinetics, pharmacodynamics, safety, rheumatoid arthritis, disease-modifying antirheumatic drugs, biologicals, proton pump inhibitors, non-steroidal anti-inflammatory drugs, лекарственные взаимодействия, нежелательные реакции, фармакокинетика, фармакодинамика, безопасность лекарственных средств, ревматоидный артрит, базисные противовоспалительные препараты, биологические препараты, ингибиторы протонной помпы
الوصف:	INTRODUCTION. Methotrexate (MTX) is the main disease-modifying antirheumatic drug (DMARD) and the gold standard for the safety and efficacy evaluation of biologicals and targeted small molecules. However, its narrow therapeutic range, interpatient variability in pharmacokinetics and pharmacodynamics, and potential clinically relevant drug–drug interactions (DDIs) may lead to treatment failure and increase the risk of adverse drug reactions (ADRs).AIM. The study aimed to describe the main clinically significant DDIs associated with MTX used in rheumatic disease therapy and determine possible approaches to addressing this issue based on a literature review.DISCUSSION. MTX is characterised by pharmacokinetic DDIs during absorption, cell penetration, and elimination. Some non-steroidal anti-inflammatory drugs (NSAIDs), theophylline, sulfasalazine, antibacterial agents, and proton pump inhibitors (PPIs) affect MTX elimination and therapeutic effects. The main ADRs associated with MTX include haematotoxicity, hepatotoxicity, lung tissue damage (interstitial pneumonitis and pulmonary fibrosis), and renal dysfunction. The severity of these ADRs depends on the dose, comorbidities, and concomitant therapy. The toxicity of MTX may be increased by the concomitant administration of medicinal products that exhibit haematotoxicity and affect renal function (impair the elimination of medicines). When co-administering MTX and medicines having clinically significant DDIs described in the literature, healthcare providers should consider the risk factors for each individual patient. The most significant risk factors include moderate to severe renal and hepatic impairment, older age, polypharmacy, and hypoalbuminemia.CONCLUSIONS. This article describes potential clinically significant interactions between MTX and certain NSAIDs, antibacterial agents, and PPIs that depend on individual patient characteristics and may increase the toxicity or decrease the effectiveness of MTX. MTX deprescribing, short-term withdrawal, and dosing ...
نوع الوثيقة:	article in journal/newspaper
وصف الملف:	application/pdf
اللغة:	Russian
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DOI:	10.30895/2312-7821-2024-416
الاتاحة:	https://www.risksafety.ru/jour/article/view/416 https://doi.org/10.30895/2312-7821-2024-416
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DOI:	10.30895/2312-7821-2024-416