Liquid chromatographic methods for the therapeutic drug monitoring of methotrexate as clinical decision support for personalized medicine: a brief review.

Liquid chromatographic methods for the therapeutic drug monitoring of methotrexate as clinical decision support for personalized medicine: a brief review. Biomed Chromatogr. 2017 Dec 11;: Authors: Silva MF, Ribeiro C, Gonçalves VMF, Tiritan ME, Lima Á Abstract Methotrexate (MTX) is an antifolate drug used for several diseases. Depending on the disease, MTX can be administered at low-dose (LDMTX) in some autoimmune diseases, like rheumatoid arthritis, or at high-dose (HDMTX) in some cancers, such as acute lymphoblastic leukaemia. After absorption, MTX is metabolized in the liver to 7-hydroxymethotrexate (7-OH-MTX) and in the intestine to 2,4-diamino-N10-methylpteroic acid (DAMPA). Moreover, inside red blood cells (RBCs), MTX is converted to active metabolites, MTX polyglutamates (MTXPGs), contributing to its pharmacodynamics. Due to its narrow therapeutic range, and inter and intra-patient variability, either non-effectiveness and/or toxicity may occur. Because of the existence of a relationship between drug therapeutic outcome and its systemic concentration, therapeutic drug monitoring (TDM) may ensure effectiveness and safety of MTX use. In order to monitor the optimization of patient clinical response profile, several analytical methods have been described for the TDM in biological samples. These include liquid chromatography (LC) coupled with ultraviolet detection (UV), fluorescence detection (FD) or mass spectrometry (MS), each...
Source: Biomedical Chromatography : BMC - Category: Biomedical Science Authors: Tags: Biomed Chromatogr Source Type: research