Study: Folic Acid Supplements May Help Those Taking Methotrexate

Patients receiving methotrexate for rheumatoid arthritis should also take folic acid supplements to counter negative side effects of the drug, according to a study reported in the March issue of the journal Rheumatology.

Methotrexate is the most commonly used disease-modifying anti-rheumatic drug in the treatment of rheumatoid arthritis, but it is often discontinued due to adverse effects.

Examining previous studies involving rheumatoid arthritis patients taking methotrexate and folate supplements, researchers at St. Peter's Hospital in England found that folate offset the elevation of homocysteine associated with the use of the drug without reducing its effectiveness.

The researchers said this offsetting effect on homocysteine may reduce the risk of cardiovascular disease, which they noted is "over-represented" among patients with rheumatoid arthritis.

"We recommend a pragmatic dosing schedule of five milligrams of oral folic acid given on the morning following the day of methotrexate administration," concluded the researchers.

Other sources: Rheumatology 2004 Mar;43(3):267-71