EMA reviewing risk of dosing errors with methotrexate

[Fred]

Spain asks The European Medicines Agency (EMA) to look at dosing errors with methotrexate in the treatment of arthritis and psoriasis.

Quote:

---

The European Medicines Agency (EMA) has started a review of the risk of dosing errors with methotrexate medicines.

When used for inflammatory diseases, such as arthritis and psoriasis, methotrexate is taken once a week whereas for some types of cancer, the dose is higher and the medicine is used more frequently. Mistakes have led to some patients incorrectly receiving a dose every day instead of every week. As a result, patients have received too much of the medicine, with serious consequences in some cases.

The risk of dosing errors with methotrexate has been recognised for many years and several measures are already in place in some EU countries to reduce this risk, including the use of visual reminders on the medicine packs. However, a recent assessment found that serious adverse events related to overdose, including fatalities, are still occurring. The Spanish medicines regulator, AEMPS, therefore asked EMA to further investigate the reasons why dosing errors continue to occur in order to identify measures to prevent them.

EMA’s Pharmacovigilance Risk Assessment Committee (PRAC) will now examine the available evidence and recommend whether further measures are needed to minimise the risk of dosing errors. The PRAC will also take into account the work of bodies specialising in patient safety.

Source: ema.europa.eu

[Fred]

Another reason to ban this poison from being used to treat psoriasis.

There are many better treatments out there today, stop using this crap on psoriasis patients.

[jiml]

The chance of dosing mistakes is probably more for tablets rather than injections I would imagine. I don’t like methotrexate but it does work of that there is no doubt ....but agree there are far better treatments... but it always comes down to price and with methotrexate being the cheap option it will always be first choice for health services, despite the risks

[Maryam]

Dosingn errors are human errors. The same could happen with Humira, an injection everyday instead of bi-weekly. I think a lot of people in the USA are happy with this relatively cheap medicine as a lot of people don’t have insurance and pay for it themselves. Although far from perfect, some alternatives are not accessible for a lot of people.

[jiml]

Dosingn errors are human errors. The same could happen with Humira, an injection everyday instead of bi-weekly. I think a lot of people in the USA are happy with this relatively cheap medicine as a lot of people don’t have insurance and pay for it themselves. Although far from perfect, some alternatives are not accessible for a lot of people.

Very true Maryam many treatments are out of reach of many sufferers,  as you say in America where without insurance the costs are prohibitive there aren’t many options, other than methotrexate or diet that are affordable

[D Foster]

MTX is still a good treatment for both P and PsA , dosing problems is not the fault of the drug and I agree injections are less likely to cause problems in that area . If you were to overdose with 90% of the drugs on the market there would be consequences and that includes some of the very simple ones in fact vitamins as well.
It is a cost effective drug but that's because it's used so widely and it's cheap to produce unlike some on the market which is not the fault of the MTX !
It is not a poison no more than any other is , aspirin and especially paracetamol which are very cheap drugs are just as poisonous if you take too many .
Most drugs on the market are used for all sorts of complaints and treatments in fact they are finding new ones all the time for them , there are drugs used in operations and pain killers that have been used to dispatch people but does not mean that used correctly they are not good drugs.

[Fred]

Sorry I stand by what I said "It should no longer be used to treat psoriasis patients.

It doesn't work any better than any other oral treatment. And it never helped me one bit with psoriatic arthritis.

As for the cost, I don't know the cost of each treatment apart from knowing the Bio's are the most expensive. But DMF is cheap and a lot better at treating psoriasis, this has been proven by our own members.

Also when you look at the cost, do you take into account how some people suffer with methotrexate. We don't know how much it effects their quality of life and in turn their work, and how many have to have expensive tests on monitoring their liver. I don't know again the cost of those tests, but it all adds up as do the other pills your doctor will throw at you to stop the nausea.

How many people stay on methotrexate and how many fail. My guess would be that 90% end up having to move onto something else, either because it's noit working or it's making the life unbearable.

I'm not saying methotrexate doesn't have a place in medicine, but it doesn't need to be used today in treating psoriasis. It's track record is no longer good enough up against other treatments and it's time dermatologists moved on. By starting people on methotrexate they risk a lot of patients not going back as they think the other treatments will probably be the same.

It's poison, it's outdated and it's no longer needed in the treatment of psoriasis today.

Good luck to those of you that do use it and get a result you are happy with, but it's not for me and it's certainly not something I would recommend to newly diagnosed.

[Bill]

I don't carry any affection for mtx, but I think it would be a very bad idea to disallow its use. Yes, DMF could be incredibly cheap, perhaps even more effective than it is presently, but the best results with conventional use fall short of mtx, and the mindset of regulators is not conducive for innovation. As for diet, I believe it has a small benefit at best and is bad advice as a single measure for a substantial disease.

For all its faults I can see why mtx is so widely used.

[mataribot]

You can get away with a rather large does MTX as long as it’s only taken only once per week. The ODs more than likely has to do with frequency. There are so many safe and effective treatments for Psoriasis these days, this drug should be at the bottom of the list.

[D Foster]

There are several other oral treatments that I would not take instead of MTX which I had far worse side effects from than MTX , cyclosporine and Acitretin to name two. Cyclosporine was so bad that I really thought that I was dying and I was on business in Germany at the time, it was a nightmare that still haunts me, flying home was really a blur thankfully I was not on commercial airlines but then again many people take it without any problems at all.
My Doctor takes MTX for his arthritis and he is ok on it in fact he swears by it , I don't think you can condemn any treatment if it works and MTX does work for some people