Hospital Outcomes

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Use of Voraxaze Leads to Reduced Length of Stay and Reduced Mortality Rates 

In a retrospective study of Medicare patients with cancer, patients treated with Voraxaze® (glucarpidase) had all of the following benefits compared with nonglucarpidase patients treated with dialysis (dialysis+) and nonglucarpidase patients with or without dialysis treatment (dialysis+/-), respectively ,*:

  • Shorter mean hospital length of stay (14.7 days vs 40.2 days and 21.9 days)
  • Shorter mean intensive care unit (ICU) length of stay (4.0 days vs 18.2 days in the dialysis+ group)
  • Lower inpatient mortality rates (3.3% vs 50.6% and 20.8%)
  • Lower 90-day mortality rates (16.7% vs 58.6% and 37.6%)

*Utilizing Medicare inpatient claims data between 2010 and 2017, investigators compared outcomes and healthcare resource utilization between patients treated with Voraxaze (n=30) and patients not treated with Voraxaze (n=701), all of whom had experienced acute kidney injury secondary to inpatient chemotherapy.1

Mean length of stay (LOS) among patients treated with Voraxaze and the non-Voraxaze groups 

Mean length of stay (LOS) among patients treated with Voraxaze and the non-Voraxaze groups

Source: ClinicoEconomics and Outcomes Research 2019:11 129-144. Adapted and used with permission from Dove Medical Press Ltd.

Rates of mortality among patients treated with Voraxaze and the non-Voraxaze groups 

Rates of mortality among patients treated with Voraxaze and the non-Voraxaze groups

Source: ClinicoEconomics and Outcomes Research 2019:11 129-144. Adapted and used with permission from Dove Medical Press Ltd.

Early vs Late Treatment With Voraxaze 

Length of stay in hospital was 54% shorter and ICU stay was 91% shorter with earlier administration of Voraxaze.

 

Early cohort

Late cohort

Overall length of stay

10.0 days

21.7 days (P=0.002)

Length of hospital stay after Voraxaze

8.5 days

14.6 days (P=0.057)

Length of ICU stay

0.8 days

8.9 days (P=0.020)

Trust Voraxaze for Rapid and Sustained Reductions in MTX 

Not every patient requires Voraxaze, but experts have assembled recommendations to help guide treatment.

Explore guidelines for the use and stocking of Voraxaze so that you’re prepared in an emergency.

References
1.

Demiralp B, Koenig L, Kala J, et al. Length of stay, mortality, and readmissions among Medicare cancer patients treated with glucarpidase and conventional care: a retrospective study. Clinicoecon Outcomes Res. 2019;11:129-144.

2.

Voraxaze®. Prescribing information. BTG International Inc.; 2019.

Indication and Important Safety Information
Indication and Limitations of Use
  • Voraxaze® is a carboxypeptidase indicated to reduce toxic plasma methotrexate concentration (greater than 1 micromole per liter) in adult and pediatric patients with delayed methotrexate clearance (plasma methotrexate concentrations greater than 2 standard deviations of the mean methotrexate excretion curve specific for the dose of methotrexate administered) due to impaired renal function
  • Limitations of Use: Voraxaze® is not recommended for use in patients who exhibit the expected clearance and expected plasma methotrexate concentration. Reducing plasma methotrexate concentration in these patients may result in subtherapeutic exposure to methotrexate
Important Safety Information
WARNINGS AND PRECAUTIONS

Serious Hypersensitivity Reactions

  • Serious hypersensitivity reactions, including anaphylactic reactions, may occur. Serious hypersensitivity reactions occurred in less than 1% of patients

Monitoring Methotrexate Concentration/Interference with Assay

  • Methotrexate concentrations within 48 hours following Voraxaze® administration can only be reliably measured by a chromatographic method due to interference from metabolites. Measurement of methotrexate concentrations within 48 hours of Voraxaze® administration using immunoassays results in an overestimation of the methotrexate concentration

ADVERSE REACTIONS

  • In clinical trials, the most common related adverse events (occurring in >1% of patients) were paresthesia, flushing, nausea and/or vomiting, hypotension and headache

DRUG INTERACTIONS

  • Voraxaze® can decrease leucovorin concentration, which may decrease the effect of leucovorin rescue unless leucovorin is dosed as recommended, and may also reduce the concentrations other folate analogs or folate analog metabolic inhibitors

Please see full Prescribing Information.