Folate supplementation and methotrexate treatment in rheumatoid arthritis: a review

Whittle, Samuel L

doi:10.1093/rheumatology/keh088

Cited by 218 publications

(143 citation statements)

References 32 publications

Supporting

Mentioning

126

Contrasting

Unclassified

Order By: Relevance

“…Most of our RA patients (74%) were treated with methotrexate, currently the standard traditional disease-modifying anti-rheumatic drug, which is a folate antagonist. As folic acid supplements (5 mg) have been prescribed routinely to all patients receiving methotrexate for the treatment of RA (Whittle and Hughes, 2004), all patients were simultaneously supplemented with 5 mg/day folic acid to compensate for the folate-depleting side effect of methotrexate. The intervention dose (100 mg/day) of vitamin B 6 is 62.5 times higher than the current Taiwan dietary reference intake (Department of Health, Taiwan, 2003) of 1.6 mg/day for men and women aged 451 years.…”

Section: Experimental Protocolmentioning

confidence: 99%

Vitamin B6 supplementation improves pro-inflammatory responses in patients with rheumatoid arthritis

Wei

et al. 2010

Eur J Clin Nutr

102

View full text Add to dashboard Cite

Background/Objectives: The purpose of this study was to investigate whether vitamin B 6 supplementation had a beneficial effect on inflammatory and immune responses in patients with rheumatoid arthritis (RA). Subjects/Methods: This was a single-blind co-intervention study performed at the Division of Allergy, Immunology and Rheumatology of Chung Shan Medical University Hospital, Taiwan. Patients were diagnosed with RA according to the 1991 American College of Rheumatology criteria for RA. Patients were randomly allocated into two groups: control (5 mg/day folic acid only; n ¼ 15) or vitamin B 6 (5 mg/day folic acid plus 100 mg/day vitamin B 6 ; n ¼ 20) for 12 weeks. Plasma pyridoxal 5 0 -phosphate (PLP), serum folate, inflammatory parameters (that is, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a)) and immune parameters (that is, white blood cell, total lymphocyte, T-cell (CD3), B-cell (CD19), T-helper cell (CD4), T-suppressor (CD8)) were measured on day 1 (week 0) and after 12 weeks (week 12) of the intervention. Results: In the group receiving vitamin B 6 , plasma IL-6 and TNF-a levels significantly decreased at week 12. There were no significant changes with respect to immune responses in both groups except for the percentage of total lymphocytes in the vitamin B 6 group when compared with week 0 and week 12. Plasma IL-6 level remained significantly inversely related to plasma PLP after adjusting for confounders (b ¼ À0.01, P ¼ 0.01). Conclusions: A large dose of vitamin B 6 supplementation (100 mg/day) suppressed pro-inflammatory cytokines (that is, IL-6 and TNF-a) in patients with RA.

show abstract

Section: Experimental Protocolmentioning

confidence: 99%

Vitamin B6 supplementation improves pro-inflammatory responses in patients with rheumatoid arthritis

Wei

et al. 2010

Eur J Clin Nutr

102

View full text Add to dashboard Cite

show abstract

“…Although MTX was proved to be effective in the treatment of both RA and many cancers, discontinuation is common due to occurrence of its adverse effects [7] . There are many evidences that low dose of MTX can reache high concentration in bone as reported by Bologna et al, who found that MTX concentration in cortical and trabecular bone was 13 and 11.5 fold higher than plasma concentration of same drug [8] .…”

Section: Introductionmentioning

confidence: 99%

The Protective Role of Simvastatin on Methotrexate-Induced Bone Injury in Adult Albino Rat

Elsaid

Sadek

2017

Egyptian Journal of Histology

View full text Add to dashboard Cite

Background: Methotrexate (MTX) is a folic acid antagonist and chemotherapeutic agent widely used in cancer treatment. It is used as first line therapy in treatment of rheumatoid arthritis (RA). MTX was known to cause bone defects in the form of reduced mineral density (BMD) and bone fractures. Simvastatin (SIM) is widely used for cardiovascular diseases. Aim of Work: To investigate the possible protective role of SIM on MTX induced bone injury in rats. Material and Methods: Forty adult male albino rats were divided into four groups; Control group, SIM-treated group, MTX group and MTX + SIM group. MTX was given by subcutaneous injection as 0.65 mg/kg/day for two separate 5 days. SIM was administered orally as 25 mg/kg/day one month prior to and during the MTX course. At the end of the experiment, blood samples were collected for levels of osteocalcin (OSC) and alkaline phosphatase (ALP). All rats were sacrificed and specimens from their femurs were examined. Results: examination of MTX group showed marked thinning of the periosteum, and widening of bone marrow spaces. There was an apparent decrease in the number of osteocytes, together with an apparent increase in the number of osteoclasts. There was a significant decrease in the serum level of OSC together with a highly significant increase in the serum level of ALP in the MTX group as compared to the control group. On administration of SIM with MTX, there was marked improvement in most of the histological and serological parameters. Conclusion: SIM could be used as a protective measure for MTX-induced bone defects.

show abstract

“…Moreover, high MCV value (as observed in this study) has been recognized as a possible predictor of potential hematological toxicity and should be closely monitored and regulated [29,30].…”

Section: Resultsmentioning

confidence: 62%

Safety and efficacy of Methotrexate Monotherapy Vs Methotrexate Plus Leflunomide Combination Therapy in Early Active Rheumatoid Arthritis Patients

Boshra¹,

Ahmed²,

Salem³

et al. 2016

Med-Science

View full text Add to dashboard Cite

show abstract

Folate supplementation and methotrexate treatment in rheumatoid arthritis: a review

Abstract: We propose that folic acid supplements be prescribed routinely to all patients receiving MTX for the treatment of RA. We recommend a pragmatic dosing schedule of 5 mg of oral folic acid given on the morning following the day of MTX administration.

Cited by 218 publications

References 32 publications

Vitamin B6 supplementation improves pro-inflammatory responses in patients with rheumatoid arthritis

Vitamin B6 supplementation improves pro-inflammatory responses in patients with rheumatoid arthritis

The Protective Role of Simvastatin on Methotrexate-Induced Bone Injury in Adult Albino Rat

Safety and efficacy of Methotrexate Monotherapy Vs Methotrexate Plus Leflunomide Combination Therapy in Early Active Rheumatoid Arthritis Patients

Contact Info

Product

Resources

About