Categories
Change Password!
Reset Password!
RA patients on MTX therapy should be supplemented
with folate as it may significantly decrease the incidence of hepatotoxicity, gastrointestinal
side effects and patient withdrawal from MTX.
A recent study by Liu, Lijun and colleagues revealed
that folate supplementation reduce the incidence of
side-effects of methotrexate therapy in patients with rheumatoid arthritis.
The systematic
review was conducted to evaluate whether folic acid supplementation reduces the
MTX toxicity or reduces MTX benefits and decided whether a higher MTX dosage is
essential.
Dr Liu, Lijun et
al. performed a sensitive search for abstracts from important rheumatology
meetings, and major trial registers were also searched to retrieve all
randomized controlled trials and database of Medline, Embase, Web of Science
and Cochrane Library databases from inception to 2 June 2016 systematically.
A total of 7
studies were included with 709 patients. It was found that RA patients treated
with MTX, supplemented with folic acid were less likely to have elevated
transaminase (odds ratio [OR] 0.15; 95% confidence interval [95% CI] 0.10, 0.23
[P < 0.00001]) and gastrointestinal side-effects such as nausea and vomiting
(OR 0.71; 95% CI 0.51, 0.99 [P = 0.04]).
The folate
supplementation reduced patient withdrawal compared to placebo (OR 0.29; 95% CI
0.21, 0.42 [P < 0.00001]). Whereas, no statistical difference for mouth
sores between folate and placebo (OR 0.83; 95% CI 0.57, 1.22 [P = 0.35]) were
found. The disease activity markers in included trials were not consistent and
so it was not possible to decide if folate supplementation reduced MTX efficacy
or not.
The scientists also
compared the high-dose of folate (≥25 mg per week) with low-dose folate (≤10 mg
per week) on MTX efficacy, but no statistical difference (OR 2.07; 95% CI 0.81,
5.30 [P = 0.13]), on MTX toxicity (OR 1.56; 95% CI 0.80,3.04 [P = 0.19]) was
observed.
Journal of Clinical Rhematology
Folate Supplementation for Methotrexate Therapy in Patients With Rheumatoid Arthritis: A Systematic Review.
Liu, Lijun et al.
Comments (0)