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Folate supplementation and methotrexate

B A Dijkmans1

  • 1Department of Rheumatology, University Hospital Leiden, The Netherlands.

British Journal of Rheumatology
|December 1, 1995
PubMed
Summary

Folate supplementation does not affect methotrexate efficacy in rheumatoid arthritis. However, it may favorably influence methotrexate toxicity, warranting further research into optimal supplementation strategies.

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Effect of folic or folinic acid supplementation on the toxicity and efficacy of methotrexate in rheumatoid arthritis: a forty-eight week, multicenter, randomized, double-blind, placebo-controlled study.

Arthritis and rheumatism·2001

Area of Science:

  • Rheumatology
  • Pharmacology
  • Nutritional Science

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease.
  • Methotrexate (MTX) is a primary disease-modifying antirheumatic drug (DMARD) for RA.
  • Folate supplementation is often used alongside MTX, but its impact on MTX outcomes requires clarification.

Purpose of the Study:

  • To review the influence of folate supplementation on the toxicity and efficacy of methotrexate in rheumatoid arthritis patients.
  • To analyze variations in study designs, folate types, and timing of supplementation across controlled trials.

Main Methods:

  • Systematic review of six published controlled studies.
  • Analysis of data concerning methotrexate efficacy and toxicity in rheumatoid arthritis patients receiving folate supplementation.

Main Results:

  • Folate supplementation demonstrated no significant impact on the efficacy of methotrexate in treating rheumatoid arthritis.
  • A potential favorable influence of folate supplementation on methotrexate-induced toxicity was observed.

Conclusions:

  • Folate supplementation appears to be safe regarding methotrexate efficacy in RA.
  • Further investigation is required to determine optimal folate supplementation types (e.g., folic acid, folinic acid), identify factors predisposing to toxicity, and assess cost-effectiveness.

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