Tags

Type your tag names separated by a space and hit enter

Folic acid supplementation prevents deficient blood folate levels and hyperhomocysteinemia during longterm, low dose methotrexate therapy for rheumatoid arthritis: implications for cardiovascular disease prevention.

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.

Links

  • clinical trials
  • Authors+Show Affiliations

    ,

    Department of Nutrition Sciences, School of Medicine, University of Alabama at Birmingham, USA. slmorgan@uab.edu

    , ,

    Source

    The Journal of rheumatology 25:3 1998 Mar pg 441-6

    MeSH

    Adult
    Aged
    Antirheumatic Agents
    Arthritis, Rheumatoid
    Cardiovascular Diseases
    Dietary Supplements
    Double-Blind Method
    Female
    Folic Acid
    Folic Acid Antagonists
    Folic Acid Deficiency
    Homocysteine
    Humans
    Male
    Methotrexate
    Middle Aged

    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/full_citation L2 - https://ClinicalTrials.gov/search/term=9517760 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -