Interpretation for Evidence-based Practice Guideline of Medication Therapy of High-dose Methotrexate in China
- VernacularTitle:《中国大剂量甲氨蝶呤循证用药指南》解读
- Author:
Zaiwei SONG
1
,
2
;
Shuang LIU
1
,
2
;
Rongsheng ZHAO
1
,
2
;
Suodi ZHAI
1
,
2
;
Xianglin ZHANG
3
;
Youping LI
4
;
Guanhua DU
5
;
Yuankai SHI
6
;
Liyan MIAO
7
;
Lingli ZHANG
8
;
Hongmei JING
9
Author Information
1. Dept. of Pharmacy，Peking University Third Hospital，Beijing 100191，China
2. Institute for Drug Evaluation，Peking University Health Science Center，Beijing 100191，China
3. Dept. of Pharmacy，China ⁃ Japan Friendship Hospital，Beijing 100029，China
4. Chinese Evidence-based Medicine Center，West China Hospital of Sichuan University，Chengdu 610041，China
5. Beijing Key Laboratory of Drug Target Identification and Drug Screening，Institute of Materia Medica，Chinese Academy of Medical Sciences & Peking Union Medical College，Beijing 100050，China
6. Dept. of Internal Medicine，Cancer Hospital，Chinese Academy of Medical Sciences & Peking Union Medical College，Beijing 100021，China
7. Dept. of Pharmacy，the First Affiliated Hospital of Soochow University，Jiangsu Suzhou 215006，China
8. Dept. of Pharmacy，West China Second University E-mail：songzw445@126.com Hospital，Sichuan University，Chengdu 610044，China
9. Dept. of Hematology，Peking University Third Hospital，Beijing 100191，China
- Publication Type:Journal Article
- Keywords:
clinical practice guideline;
high-dose methotrexate;
evidence-based medication;
therapeutic drug monitoring
- From:
China Pharmacy
2022;33(16):2032-2039
- CountryChina
- Language:Chinese
-
Abstract:
Evidence-based Practice Guideline of Medication Therapy of High-dose Methotrexate in China was published in the British Journal of Clinical Pharmacology in February 2022. The guideline followed the latest definition of clinical practice guideline and the methodology specification for the guideline development of WHO. The Grading of Recommendations Assessment ， Development，and Evaluation （GRADE）approach was applied to rate the quality of evidence and determine the strength of recommendations. Finally ，this guideline presents 28 recommendations covering the whole process of clinical medication of high-dose methotrexate ，involving evaluation prior to administration （liver and renal function ，pleural effusion and ascites ， comedication，genetic testing ），pre-treatment and routine dosing regimen （pretreatment of hydration and alkalization ，urine alkalization，routine dosing regimen ），therapeutic drug monitoring （necessity，method，timing，target concentration ），leucovorin rescue（rescue timing ，rescue regimen ，rescue dose optimization ），and management of toxicities （liver and kidney function monitoring，supportive treatment ，blood purification treatment ）. This article aims to summarize and interpret the recommendations of this guideline ，so as to promote the better promotion and implementation of this guideline and provide comprehensive technical support and suggestions for whole-course individualized administration of high-dose methotrexate in China.
