OBJECTIVE: To analysis the literature analysis of methotrexate (MTX) plasma concentration monitoring in China, and provide reference for developing MTX individual regimen. METHODS: Retrieved from PubMed, CJFD 、 VIP database and Wanfang database, literatures about patients using MTX for plasma concentration monitoring in China were enrolled, the diseases, monitoring numbers, monitoring methods and time points, rescue time and stop standard of leucovorin (CF), reference concentration standard, literature types and quality of patients were summarized. RESULTS: Totally 146 literature were included, involving 6 109 patients and 20 000 cases of MTX concentration monitoring results. In this investigation, 53 were prospective study, 93 were retrospective study. Results showed, totally 75 MTX monitoring literatures were published from Jan. 2005 to Del. 2009 caccounting for 51.4%; the monitoring method of MTX were mainly FPIA and HPLC; the monitoring time of 43.5% literatures was 24,48,72,96 h after administration,which was recommenoled by the Food and Drug Administration(FDA); 56.1% took use of standard concentration of MTX(24 h≤10 μmol/L,48 h≤1 μmol/L,72 h≤0.2 μmol/L),which was recommended by FDA. In acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma(NHL), the beginning time of using CF was generally 36 h after administration, while beginning time of using CF was generally 6 h and 12 h in osteosarcoma; 73.6% stopped to use CF when the MTX concentration under 0.1 μmol/L, while only 8.3% stopped when the MTX concentration under 0.05 μmol/L that was FDA recommended concentration. CONCLUSIONS: The monitoring time points, concentration standard, beginning time of CF and stopping concentration for MTX has not been completely reunificated but researches unanimity. Based on MTX metabolic characteristics of Chinese, it is suggested that relevant departments should establish domestic plasma concentration guidance for MTX to better guide MTX plasma concentration in clinic for individual regimen.
关键词
甲氨蝶呤治疗药物监测血药浓度文献分析
Keywords
MethotrexateTherapeutic drug monitoringPlasma concentrationLiterature analysis