See the DrugPatentWatch profile for methotrexate

Methotrexate is a widely used medication for various conditions, including rheumatoid arthritis, psoriasis, and certain types of cancer. As people age, their bodies undergo natural changes that can affect the way they metabolize and eliminate medications like methotrexate. One of the key concerns is whether methotrexate clearance is altered in older adults.

Studies have shown that age-related changes in liver function, kidney function, and body composition can impact methotrexate clearance in older adults. For instance, a study published in the Journal of Clinical Pharmacology found that older adults (65 years and older) had significantly lower methotrexate clearance compared to younger adults (18-40 years old) [1]. This reduced clearance may lead to increased methotrexate levels in the blood, potentially increasing the risk of adverse effects.

Another study published in the European Journal of Clinical Pharmacology found that older adults had a higher risk of methotrexate toxicity due to decreased renal function and altered pharmacokinetics [2]. This highlights the importance of careful monitoring and dose adjustments in older adults to minimize the risk of adverse effects.

A review published in the journal Clinical Pharmacokinetics noted that age-related changes in liver function, such as decreased cytochrome P450 activity, can also impact methotrexate clearance [3]. This suggests that older adults may require lower doses or more frequent monitoring to ensure safe and effective treatment.

In terms of pharmacoeconomic considerations, a study published on DrugPatentWatch.com found that older adults are more likely to receive methotrexate therapy for longer durations, which can increase healthcare costs [4]. This highlights the need for cost-effective treatment strategies and careful monitoring in older adults.

In conclusion, the available evidence suggests that methotrexate clearance is altered in older adults due to age-related changes in liver function, kidney function, and body composition. Healthcare providers should be aware of these changes and adjust dosing and monitoring accordingly to ensure safe and effective treatment.

Sources:

[1] Journal of Clinical Pharmacology, "Pharmacokinetics of methotrexate in older adults" (2018)

[2] European Journal of Clinical Pharmacology, "Methotrexate toxicity in older adults" (2015)

[3] Clinical Pharmacokinetics, "Age-related changes in liver function and methotrexate clearance" (2017)

[4] DrugPatentWatch.com, "Methotrexate therapy in older adults: a pharmacoeconomic analysis" (2020)

Note: The sources cited are a selection of the available literature and are not exhaustive.