Drug–drug interaction between methotrexate and levetiracetam in a child treated for acute lymphoblastic leukemia

Parentelli, Anne-Sophie; Phulpin-Weibel, Aurélie; Mansuy, L; Contet, Audrey; Tréchot, P.; Chastagner, Pascal

doi:10.1002/pbc.24371

Cited by 18 publications

(18 citation statements)

References 7 publications

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“…Other reports included rash, weight loss, depression, autistic regression, acute pancreatitis, elevated alkaline phosphatase, thrombocytopaenia, interstitial nephritis and interstitial lung disease (Table D in S1 Table ). The single report of drug interaction was a case of renal failure in a 15 year old boy who received methotrexate for acute lymphoblastic leukaemia [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

Safety of Levetiracetam in Paediatrics: A Systematic Review

2016

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ObjectiveTo identify adverse events (AEs) associated with Levetiracetam (LEV) in children.MethodsDatabases EMBASE (1974-February 2015) and Medline (1946-February 2015) were searched for articles in which paediatric patients (≤18 years) received LEV treatment for epilepsy. All studies with reports on safety were included. Studies involving adults, mixed age population (i.e. children and adults) in which the paediatric subpopulation was not sufficiently described, were excluded. A meta-analysis of the RCTs was carried out and association between the commonly reported AEs or treatment discontinuation and the type of regimen (polytherapy or monotherapy) was determined using Chi2 analysis.ResultsSixty seven articles involving 3,174 paediatric patients were identified. A total of 1,913 AEs were reported across studies. The most common AEs were behavioural problems and somnolence, which accounted for 10.9% and 8.4% of all AEs in prospective studies. 21 prospective studies involving 1120 children stated the number of children experiencing AEs. 47% of these children experienced AEs. Significantly more children experienced AEs with polytherapy (64%) than monotherapy (22%) (p<0.001). Levetiracetam was discontinued in 4.5% of all children on polytherapy and 0.9% on monotherapy (p<0.001), the majority were due to behavioural problems.ConclusionBehavioural problems and somnolence were the most prevalent adverse events to LEV and the most common causes of treatment discontinuation. Children on polytherapy have a greater risk of adverse events than those receiving monotherapy.

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Section: Resultsmentioning

confidence: 99%

Safety of Levetiracetam in Paediatrics: A Systematic Review

2016

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“…We performed a search of bibliographic databases and identified only eight studies, all case reports, that suggested a greater risk of AKI with levetiracetam (Supplemental Table 3). In these reports, four cases of AKI were attributed to interstitial nephritis, two to rhabdomyolysis, and one to a pharmacokinetic interaction with methotrexate (7)(8)(9)(10)(11)(12)(13)(14). Therefore, to provide additional safety data we conducted this population-based cohort study to determine whether levetiracetam use is associated with a higher risk of AKI compared with nonuse.…”

Section: Introductionmentioning

confidence: 99%

Population-Based Study of Risk of AKI with Levetiracetam

Yau

Burneo

Jandoc

et al. 2018

CJASN

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Background and objectives Regulatory agencies warn about the risk of AKI with levetiracetam use on the basis of information from case reports. We conducted this study to determine whether new levetiracetam use versus nonuse is associated with a higher risk of AKI.Design, setting, participants, & measurements This was a population-based retrospective cohort study of adults with epilepsy in Ontario, Canada. Patients who received a new outpatient prescription for levetiracetam between January 1, 2004 and March 1, 2017 were matched to two nonusers on stage of CKD, recorded seizure in the prior 90 days, and logit of a propensity score for levetiracetam use. The primary outcome was a hospital encounter (emergency department visit or hospitalization) with AKI within 30 days of cohort entry. Secondary outcomes were AKI within 180 days and change in the concentration of serum creatinine. We assessed the primary outcome using health care diagnosis codes. We evaluated the change in the concentration of serum creatinine in a subpopulation with laboratory measurements. ResultsWe matched 3980 levetiracetam users to 7960 nonusers (mean age 55 years, 51% women). Levetiracetam use was not significantly associated with a higher risk of AKI within 30 days (13 [0.33%] events in levetiracetam users and 21 [0.26%] events in nonusers [odds ratio, 1.24; 95% confidence interval, 0.62 to 2.47]). Similarly, there was no significant association with AKI within 180 days (odds ratio, 0.70; 95% confidence interval, 0.43 to 1.13). The change in the concentration of serum creatinine did not significantly differ between levetiracetam users and nonusers. ConclusionsIn this population-based study levetiracetam use was not associated with a higher risk of AKI.

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“…There is no report on the interactions between LEV and any other drug, except for a few case reports. [ 8 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…reported a case of leukemia with potential risk of drug-drug interaction between LEV and methotrexate. [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

Intravenous levetiracetam in critically ill children

İncecik

Horoz

Hergüner

et al. 2016

Ann Indian Acad Neurol

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Background:To report the effectiveness and safety of intravenous (IV) levetiracetam (LEV) in the treatment of critically ill children with acute repetitive seizures and status epilepticus (SE) in a children's hospital.Materials and Methods:We retrospectively analyzed data from children treated with IV LEV.Results:The mean age of the 108 children was 69.39 ± 46.14 months (1-192 months). There were 58 (53.1%) males and 50 (46.8%) females. LEV load dose was 28.33 ± 4.60 mg/kg/dose (10-40 mg/kg). Out of these 108 patients, LEV terminated seizures in 79 (73.1%). No serious adverse effects were observed but agitation and aggression were developed in two patients, and mild erythematous rash and urticaria developed in one patient.Conclusion:Antiepileptic treatment of critically ill children with IV LEV seems to be effective and safe. Further study is needed to elucidate the role of IV LEV in critically ill children.

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Drug–drug interaction between methotrexate and levetiracetam in a child treated for acute lymphoblastic leukemia

Abstract: Fig. 1. Serum MTX and creatinine concentrations after MTX infusion. Ã Methotrexate.

Cited by 18 publications

References 7 publications

Safety of Levetiracetam in Paediatrics: A Systematic Review

Safety of Levetiracetam in Paediatrics: A Systematic Review

Population-Based Study of Risk of AKI with Levetiracetam

Intravenous levetiracetam in critically ill children

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