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A pilot randomized controlled double-blind trial of high- vs low-dose weekly folic acid in people with rheumatoid arthritis receiving methotrexate

Journal of Clinical Rheumatology Oct 12, 2019

Stamp LK, O'Donnell JL, Frampton C, et al. - Through randomized double-blind randomized controlled trial comparing 5 mg/wk and 0.8 mg/wk folic acid, experts ascertained whether decreasing the dose of supplemental folic acid used in conjunction with methotrexate (MTX) therapy in individuals with active RA enhanced disease control and/or improved MTX-related adverse impacts. Forty participants were enrolled. No important variation in the change in DAS28 between the high- and low-dose groups at 24 weeks was noted. No meaningful variation in MTX-related adverse events between the two groups was seen. Therefore, a decrease in RBC folate secondary to a decline in folic acid dose was not related to a shift in RA disease activity or MTX-related adverse impacts. Moreover, for co-prescribing folic acid with MTX, the prevention of MTX-related adverse impacts continues to be the primary reason.
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