EMA reviewing risk of dosing errors with methotrexate

[D Foster]

There is no reason to start off with MTX.

Correct.

Most westernized countries have funding for the poor.

Correct.

MTX doesn’t prevent or slow down PsA

Correct.

Sorry but I must contradict somewhat , 1/ incorrect 2/ MOST but not all by a long way. 3/ incorrect yes it does for some people .

[mataribot]

There are several large scale studies that show MTX does not prevent bone damage nor slow it down for PsA It make some people feel better (pointed in the right direction), but that’s it.

[Fred]

Update to this thread:

Quote:

---

EMA’s safety committee (PRAC) is recommending new measures to avoid dosing errors that have led to some patients incorrectly taking methotrexate-containing medicines daily instead of weekly.

The new measures include restricting who can prescribe these medicines, making warnings on the packaging more prominent and providing educational materials for patients and healthcare professionals. In addition, to help patients follow the once-weekly dosing, methotrexate tablets for weekly use will be provided in blister packs and not in bottles (or tubes).

Methotrexate is used for treating both inflammatory diseases and cancers. When used for inflammatory diseases, such as arthritis and psoriasis, it is taken once a week but for some types of cancer, a much higher dosage is needed and the medicine is taken more frequently. Mistakes in prescribing or dispensing methotrexate as well as misunderstandings of the dosing schedule have led to patients taking the medicine daily instead of weekly for inflammatory diseases, with serious consequences, including fatalities.

The risk of dosing errors with methotrexate-containing medicines is well known. However, despite several measures already in place, these errors continue to be reported.

The PRAC examined the available evidence and recommended additional measures to reduce dosing errors so that benefits of methotrexate-containing medicines continue to outweigh their risks. The measures were agreed after consultation with patients and healthcare professionals.

Measures to prevent dosing errors with methotrexate

    Only doctors with expertise in using methotrexate-containing medicines to prescribe them.
    Healthcare professionals to ensure that patients or carers are able to follow the once-weekly dosing schedule.
    To avoid confusion, recommendations to split the dose should be deleted from the product information for the tablet formulation.
    Packaging for all methotrexate-containing medicines for once-weekly use to include a prominent reminder of how the medicine should be used.
    Patient card emphasising the weekly dosing for inflammatory diseases to be provided with oral medicines.
    Healthcare professionals to be provided with educational materials for oral medicines and to counsel patients accordingly.

Tablets to be available in blister packs instead of bottles (or tubes) in order to help patients follow the once-weekly dosing.

The PRAC recommendations will now be sent to the Committee for Medicinal Products for Human Use (CHMP), which will adopt an opinion.

Healthcare professionals will be informed in writing of the above changes. Patients who have any concerns about their medicine in the meantime should discuss them with their doctor or pharmacist.

Source: ema.europa.eu

*Thank you Caroline.

[Caroline]

Good follow up like this, Fred ..

[Fred]

Good follow up like this, Fred .. 

[jiml]

Good follow up like this, Fred .. 

Good  article and it's terrible that it ever got prescribed wrongly, I can understand patients not understanding the instructions but not doctors prescribing wrongly
So good they are doing something

[Fred]

Good follow up like this, Fred .. 

Good  article and it's terrible that it ever got prescribed wrongly, I can understand patients not understanding the instructions but not doctors prescribing wrongly
So good they are doing something

I have a better solution. .......................................... Do not prescribe poison to treat psoriasis and move on to better treatments that they will have to use in the end anyway. You only have to trawl through posts on Psoriasis Club to see that the only things working are DMF and Bio.

[jiml]

Good follow up like this, Fred .. 

Good  article and it's terrible that it ever got prescribed wrongly, I can understand patients not understanding the instructions but not doctors prescribing wrongly
So good they are doing something

I have a better solution. .......................................... Do not prescribe poison to treat psoriasis and move on to better treatments that they will have to use in the end anyway. You only have to trawl through posts on Psoriasis Club to see that the only things working are DMF and Bio.

I agree but it's cheap and saves health services millions putting off putting patients on effective treatments for a few years
That's the only reason they make us jump through hoops and fail them before moving on
I know a few are successfully treated with methotrexate but usually it's a few months on methotrexate or cyclosporine or acetretin but they do tend to fail or have ongoing side effects that are hard to live with

[Caroline]

Good follow up like this, Fred .. 

Good  article and it's terrible that it ever got prescribed wrongly, I can understand patients not understanding the instructions but not doctors prescribing wrongly
So good they are doing something

I have a better solution. .......................................... Do not prescribe poison to treat psoriasis and move on to better treatments that they will have to use in the end anyway. You only have to trawl through posts on Psoriasis Club to see that the only things working are DMF and Bio.

I agree  but it's cheap and saves health services millions putting off putting patients on effective treatments for a few years
That's the only reason they make us jump through hoops and fail them before moving on
I know a few are successfully treated with methotrexate but usually it's a few months on methotrexate or cyclosporine or acetretin but they do tend to fail or have ongoing side effects that are hard to live with

I do not agree with the fact that it is cheap, that is a very short term vision. The damage that it causes to the human body is that worse, that after a few years of use, if you come so far, you will need so much extra care that vastly outweighs that cheap period. And as a bonus, you make live bad for the users.
Totally opposite to your treatment or any treatmen that work wel, despite it is more expensive as while using the expensive treatment you can live in a normal way, be productive, earn money and taxes, care for needy people, etc. etc. Which you could not have done with damaged organs.

[Fred]

I agree  but it's cheap and saves health services millions putting off putting patients on effective treatments for a few years
That's the only reason they make us jump through hoops and fail them before moving on
I know a few are successfully treated with methotrexate but usually it's a few months on methotrexate or cyclosporine or acetretin but they do tend to fail or have ongoing side effects that are hard to live with

I will stand corrected as you will know more than me, but isn't Fumaderm, Skilarence, Psorinovo chepaer and more effective to treat psoriasis ?

Bill's testament to how cheap it can be, not something I would recommend but he is using raw DMF and is getting much better results than any of our members using Methotrexate. The evidence is here for all to see.

People should stop defending Methotrexate as a treatment for psoriasis, it's had it's day. It may work for a while but the damage and failures are far too high, it is not cheaper in the long run as not many last long on it and have to eventually move onto DMF or Bio. It's time people woke up and dumped the drugs from way back that are proved to no longer be any good.

By saying it still is worthy after all these years is rubbish, we don't still put a coin in a box and ask to be connected to a landline so let's dump the poison and move on.

It's a poison and does not have a place any more in treating psoriasis. Grrrrrrrrrrrrrrrrrrrrr

Sorry ............................................ my thoughts are well known on here and I stand by what I say. Methotrexate is poison and no longer needed for people with psoriasis. It will not help for long and 99.9% will hate it and have to move on to DMF or Bio but I'll leave it there.