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Folic acid supplementation prevents deficient blood folate levels and hyperhomocysteinemia during longterm, low dose methotrexate therapy for rheumatoid arthritis: implications for cardiovascular disease prevention.
J Rheumatol 1998; 25(3):441-6JR

Abstract

OBJECTIVE

To determine the effect of longterm methotrexate (MTX) therapy and folic acid supplementation on folate nutriture and homocysteine levels in patients with rheumatoid arthritis.

METHODS

A double blind, placebo controlled trial lasting one year was conducted at one academic medical center. A total of 79 patients taking low dose MTX were followed up to one year. The patients were randomized to receive placebo or 5 or 27.5 mg folic acid supplementation per week.

RESULTS

Plasma and erythrocyte folate levels and plasma homocysteine levels were determined. The folate nutriture of patients taking low dose MTX declined without folic acid supplementation. Plasma homocysteine levels increased significantly over a one year period in the placebo group. Low folate nutriture and hyperhomocysteinemia occurred with greater frequency in the placebo group than in the folic acid supplemented groups.

CONCLUSION

For longterm, low dose MTX therapy, there are now at least 3 reasons to consider supplementation with folic acid (a low cost prescription): (1) to prevent MTX toxicity, (2) to prevent or treat folate deficiency, and (3) to prevent hyperhomocysteinemia, considered by many investigators to be a risk factor for cardiovascular disease.

Authors+Show Affiliations

Department of Nutrition Sciences, School of Medicine, University of Alabama at Birmingham, USA. slmorgan@uab.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9517760

Citation

Morgan, S L., et al. "Folic Acid Supplementation Prevents Deficient Blood Folate Levels and Hyperhomocysteinemia During Longterm, Low Dose Methotrexate Therapy for Rheumatoid Arthritis: Implications for Cardiovascular Disease Prevention." The Journal of Rheumatology, vol. 25, no. 3, 1998, pp. 441-6.
Morgan SL, Baggott JE, Lee JY, et al. Folic acid supplementation prevents deficient blood folate levels and hyperhomocysteinemia during longterm, low dose methotrexate therapy for rheumatoid arthritis: implications for cardiovascular disease prevention. J Rheumatol. 1998;25(3):441-6.
Morgan, S. L., Baggott, J. E., Lee, J. Y., & Alarcón, G. S. (1998). Folic acid supplementation prevents deficient blood folate levels and hyperhomocysteinemia during longterm, low dose methotrexate therapy for rheumatoid arthritis: implications for cardiovascular disease prevention. The Journal of Rheumatology, 25(3), pp. 441-6.
Morgan SL, et al. Folic Acid Supplementation Prevents Deficient Blood Folate Levels and Hyperhomocysteinemia During Longterm, Low Dose Methotrexate Therapy for Rheumatoid Arthritis: Implications for Cardiovascular Disease Prevention. J Rheumatol. 1998;25(3):441-6. PubMed PMID: 9517760.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Folic acid supplementation prevents deficient blood folate levels and hyperhomocysteinemia during longterm, low dose methotrexate therapy for rheumatoid arthritis: implications for cardiovascular disease prevention. AU - Morgan,S L, AU - Baggott,J E, AU - Lee,J Y, AU - Alarcón,G S, PY - 1998/3/28/pubmed PY - 1998/3/28/medline PY - 1998/3/28/entrez SP - 441 EP - 6 JF - The Journal of rheumatology JO - J. Rheumatol. VL - 25 IS - 3 N2 - OBJECTIVE: To determine the effect of longterm methotrexate (MTX) therapy and folic acid supplementation on folate nutriture and homocysteine levels in patients with rheumatoid arthritis. METHODS: A double blind, placebo controlled trial lasting one year was conducted at one academic medical center. A total of 79 patients taking low dose MTX were followed up to one year. The patients were randomized to receive placebo or 5 or 27.5 mg folic acid supplementation per week. RESULTS: Plasma and erythrocyte folate levels and plasma homocysteine levels were determined. The folate nutriture of patients taking low dose MTX declined without folic acid supplementation. Plasma homocysteine levels increased significantly over a one year period in the placebo group. Low folate nutriture and hyperhomocysteinemia occurred with greater frequency in the placebo group than in the folic acid supplemented groups. CONCLUSION: For longterm, low dose MTX therapy, there are now at least 3 reasons to consider supplementation with folic acid (a low cost prescription): (1) to prevent MTX toxicity, (2) to prevent or treat folate deficiency, and (3) to prevent hyperhomocysteinemia, considered by many investigators to be a risk factor for cardiovascular disease. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/9517760/Folic_acid_supplementation_prevents_deficient_blood_folate_levels_and_hyperhomocysteinemia_during_longterm_low_dose_methotrexate_therapy_for_rheumatoid_arthritis:_implications_for_cardiovascular_disease_prevention_ L2 - https://ClinicalTrials.gov/search/term=9517760 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -