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Intermittent rises in plasma homocysteine in patients with rheumatoid arthritis treated with higher dose methotrexate.
Ann Rheum Dis 2005; 64(1):141-3AR

Abstract

OBJECTIVES

To investigate the effect of higher weekly maintenance dose methotrexate (MTX) (> or =25 mg/week) on plasma homocysteine concentrations in adults with RA.

METHODS

Patients with RA were treated with high doses of MTX with adjuvant folic acid. Plasma homocysteine was determined at baseline and 1, 2, 4, 8, 12, and 48 hours after subcutaneous MTX administration. Maximum homocysteine concentrations after MTX administration were compared with baseline concentrations.

RESULTS

Fifteen patients with RA (11 women) were included, with a median age of 61 years (range 31-72) and median disease duration 7 years (range 2-32). Median MTX dose was 30 mg (range 25-40). All patients received folic acid supplementation (5-30 mg/week). Median plasma homocysteine concentration at baseline was 10.1 mumol/l (range 6.6-12.7; normal 6-15). Homocysteine concentrations increased after MTX administration by a median of 2.5 mumol/l (range 0.7-5.1). Median maximum plasma homocysteine was significantly higher than at baseline. Peak homocysteine was reached after 12 hours. No relation between serum folate concentrations and plasma homocysteine concentrations was found.

CONCLUSIONS

In patients with RA higher MTX doses with adjuvant folic acid do not increase baseline concentrations of homocysteine. An intermittent significant rise in plasma homocysteine occurs in the 48 hours after MTX administration.

Authors+Show Affiliations

Department of Rheumatology, Medisch Spectrum Twente, Enschede, The Netherlands. m.hoekstra@ziekenhuis-mst.nlNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15608313

Citation

Hoekstra, M, et al. "Intermittent Rises in Plasma Homocysteine in Patients With Rheumatoid Arthritis Treated With Higher Dose Methotrexate." Annals of the Rheumatic Diseases, vol. 64, no. 1, 2005, pp. 141-3.
Hoekstra M, Haagsma CJ, Doelman CJ, et al. Intermittent rises in plasma homocysteine in patients with rheumatoid arthritis treated with higher dose methotrexate. Ann Rheum Dis. 2005;64(1):141-3.
Hoekstra, M., Haagsma, C. J., Doelman, C. J., & van de Laar, M. A. (2005). Intermittent rises in plasma homocysteine in patients with rheumatoid arthritis treated with higher dose methotrexate. Annals of the Rheumatic Diseases, 64(1), pp. 141-3.
Hoekstra M, et al. Intermittent Rises in Plasma Homocysteine in Patients With Rheumatoid Arthritis Treated With Higher Dose Methotrexate. Ann Rheum Dis. 2005;64(1):141-3. PubMed PMID: 15608313.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intermittent rises in plasma homocysteine in patients with rheumatoid arthritis treated with higher dose methotrexate. AU - Hoekstra,M, AU - Haagsma,C J, AU - Doelman,C J A, AU - van de Laar,M A F J, PY - 2004/12/21/pubmed PY - 2005/2/18/medline PY - 2004/12/21/entrez SP - 141 EP - 3 JF - Annals of the rheumatic diseases JO - Ann. Rheum. Dis. VL - 64 IS - 1 N2 - OBJECTIVES: To investigate the effect of higher weekly maintenance dose methotrexate (MTX) (> or =25 mg/week) on plasma homocysteine concentrations in adults with RA. METHODS: Patients with RA were treated with high doses of MTX with adjuvant folic acid. Plasma homocysteine was determined at baseline and 1, 2, 4, 8, 12, and 48 hours after subcutaneous MTX administration. Maximum homocysteine concentrations after MTX administration were compared with baseline concentrations. RESULTS: Fifteen patients with RA (11 women) were included, with a median age of 61 years (range 31-72) and median disease duration 7 years (range 2-32). Median MTX dose was 30 mg (range 25-40). All patients received folic acid supplementation (5-30 mg/week). Median plasma homocysteine concentration at baseline was 10.1 mumol/l (range 6.6-12.7; normal 6-15). Homocysteine concentrations increased after MTX administration by a median of 2.5 mumol/l (range 0.7-5.1). Median maximum plasma homocysteine was significantly higher than at baseline. Peak homocysteine was reached after 12 hours. No relation between serum folate concentrations and plasma homocysteine concentrations was found. CONCLUSIONS: In patients with RA higher MTX doses with adjuvant folic acid do not increase baseline concentrations of homocysteine. An intermittent significant rise in plasma homocysteine occurs in the 48 hours after MTX administration. SN - 0003-4967 UR - https://www.unboundmedicine.com/medline/citation/15608313/Intermittent_rises_in_plasma_homocysteine_in_patients_with_rheumatoid_arthritis_treated_with_higher_dose_methotrexate_ L2 - http://ard.bmj.com/cgi/pmidlookup?view=long&pmid=15608313 DB - PRIME DP - Unbound Medicine ER -