TheraRadar
Data updated: May 26, 2026

XATMEP (methotrexate sodium)

Folic Acid Metabolism Inhibitors
Oncology Approved 2017-04-25

Xatmep is used for children with acute lymphoblastic leukemia as part of a multi-drug maintenance chemotherapy program. It also helps pediatric patients with active polyarticular juvenile idiopathic arthritis who have not responded well to or cannot tolerate initial treatments like NSAIDs. This medication provides a specialized option for managing these serious conditions in younger populations.

Source: FDA Label • AZURITY • Folate Analog Metabolic Inhibitor

How XATMEP Works

This drug works by inhibiting the enzyme dihydrofolic acid reductase, which prevents the production of tetrahydrofolates necessary for DNA synthesis and cellular replication. This process specifically targets rapidly dividing cells, such as those found in malignancies. While its exact function in treating arthritis is not fully understood, it is thought to influence immune system activity.

1
Indication
--
Phase 3 Trials
9
Years on Market

Details

Status
Prescription
First Approved
2017-04-25
Patent Cliff
2033

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Routes
ORAL
Dosage Forms
SOLUTION

Companies

Active Ingredient: METHOTREXATE SODIUM

XATMEP Approval History

2018
2019
2020
2021
2022
2023
2024
2025
2026
Original
New Indication
New Form
Label Update
3 FDA actions from 2017 to 2018
Mar 2018 SUPPL
Label · Labeling
Apr 2017 ORIGINAL
New Form · Type 3 - New Dosage Form

What XATMEP Treats

2 indications

XATMEP is approved for 2 conditions since its original approval in 2017. These indications span multiple therapeutic areas including oncology, immunology, and more.

  • Acute Lymphoblastic Leukemia
  • Polyarticular Juvenile Idiopathic Arthritis
Source: FDA Label

XATMEP Boxed Warning

SEVERE TOXIC REACTIONS, INCLUDING EMBRYO-FETAL TOXICITY Methotrexate can cause the following severe or fatal adverse reactions. Monitor closely and modify dose or discontinue methotrexate as appropriate. Bone marrow suppression [see Warnings and Precautions ( 5.1 )] Serious infections [see Warnings and Precautions ( 5.2 )] Renal toxicity and increased toxicity with renal impairment [see Warnings and Precautions ( 5.3 )] Gastrointestinal toxicity [see Warnings and Precautions ( 5.4 )] Hepatic tox...

XATMEP Competitive Set

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Filters applied: drops same-active-ingredient (505(b)(2) reformulations), route-mismatch (topical vs systemic), and cross-therapeutic-area matches in same-indication rings.

What's emerging in XATMEP's indications

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Phase 3 candidates targeting molecules with no FDA-approved drug, in indications XATMEP treats. First-in-class if their pivotal trials read out positive.

Drugs Similar to XATMEP

3 of 20

FDA-approved drugs for similar conditions. Compare mechanisms and indications to understand treatment alternatives.

JYLAMVO
METHOTREXATE
2 shared
SHORLA
Shared indications:
Acute Lymphoblastic LeukemiaPolyarticular Juvenile Idiopathic Arthritis
ACTEMRA
TOCILIZUMAB
1 shared
Roche
Shared indications:
Polyarticular Juvenile Idiopathic Arthritis
ASPARLAS
CALASPARGASE PEGOL-MKNL
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SERVIER PHARMA LLC
Shared indications:
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Clinical Trial Registry

3 trials
Trial Sponsor ID Phase Status Title
NCT02143414 results posted NCI-2014-01047 NCI-2014-01047, SWOG-S1318 Ph 2 active not recruiting Blinatumomab and Combination Chemotherapy or Dasatinib, Prednisone, and Blinatumomab in Treating Older Patients With Acute Lymphoblastic Leukemia
NCT06354439 EcZOL 77015224.6.1001.5327 Ph 4 recruiting Use of Letrozole for Ectopic Pregnancy
NCT05575297 MRFI Ph 1 completed A Drug-drug Interaction Study to Evaluate the Effect of Rifampicin and Febuxostat on the Pharmacokinetics of Methotrexate in Healthy Subjects
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Trial Timeline

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

XATMEP FDA Label Details

Indications & Usage

FDA Label (PDF)

XATMEP is indicated for the treatment of Acute Lymphoblastic Leukemia; Polyarticular Juvenile Idiopathic Arthritis.

⚠️ BOXED WARNING

WARNING: SEVERE TOXIC REACTIONS, INCLUDING EMBRYO-FETAL TOXICITY Methotrexate can cause the following severe or fatal adverse reactions. Monitor closely and modify dose or discontinue methotrexate as appropriate. Bone marrow suppression [see Warnings and Precautions ( 5.1 )] Serious infections [see ...

View full patent landscape →
7 OB patents · 1 families · 19 international docs across 4 countries

XATMEP Patents & Exclusivity

Latest Patent: Jan 2033

Patents (7 active)

US10231927 Expires Jan 2, 2033
US11116724 Expires Jan 2, 2033
US11969503 Expires Jan 2, 2033
US12396947 Expires Jan 2, 2033
US10610485 Expires Jan 2, 2033
US9855215 Expires Jan 2, 2033
US9259427 Expires Jan 2, 2033
Source: FDA Orange Book

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  • Cliff: 2033
  • 9 active patents

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Competitive Landscape

  • 20 similar drugs
  • Same target/indication analysis
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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.