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Updated: May 14, 2026

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
Folate usage in MTX-treated juvenile idiopathic arthritis (JIA) patients is inconsistent and highly variable
Gil Amarilyo1, Gil Amarlilyo1, Ornella J Rullo
1Department of Pediatric Rheumatology, University of California, Los Angeles, 10833 Le Conte Avenue, MDCC 12-430, Los Angeles, CA 90095, USA. gamarilyo@tlvmc.gov.il
Abstract:
Folate supplementation is widely accepted and utilized for the prevention of adverse events in juvenile idiopathic arthritis (JIA) patients who are treated with methotrexate. Despite the widespread use of folate supplementation, there is a lack of convincing evidence to support the role of folate in the enhancement of methotrexate efficacy and the prevention of methotrexate-related adverse events. In order to understand current practices used by experts, we surveyed 214 pediatric rheumatologists around the globe. Seventy-one unique folate supplementation regimens were reported for this study. Results indicated that folate supplementation (either in the form of folic acid or folinic acid) is inconsistent and highly variable within the United States as well as between the United States and other countries. This level of variability is often associated with lack of evidence and emphasizes the need for well-designed clinical trials to support a rational folate supplementation regimen in patients with JIA who are treated with methotrexate.
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