Low folic acid levels 'can limit success of rheumatoid arthritis treatment'
Published on 10 October 2013
Scientists have discovered that taking lower levels of folic acid with the drug methotrexate can limit the effectiveness of the treatment in patients with rheumatoid arthritis.
Folic acid is normally prescribed to be taken with methotrexate – the gold standard drug treatment for mild to moderate rheumatoid arthritis – to reduce side-effects, such as nausea.
The study by a team from the Erasmus University Medical Center in Rotterdam, the Netherlands have published in Arthritis & Rheumatism - which involved almost 400 patients - was to determine whether several one-carbon metabolism biomarkers were associated with treatment non-response and adverse events among methotrexate-administered rheumatoid arthritis patients, which proved not to be the case.
However, it was noted that lower levels of folic acid were associated with higher rates of disease activity and non-response to therapy following three months of treatment with methotrexate.
This suggests that measurement of folic acid levels may be used as a means of predicting how patients will respond to methotrexate, an understanding that could help to ensure that sufferers of the disease receive better tailored and more personalised treatment regimens in future.
Rheumatoid arthritis is estimated to affect around 400,000 people in England and Wales, occurring more frequently in women than men and occurring between the ages of 40 and 70 more commonly than others.
However, people of all ages are potentially susceptible to the condition, which occurs when the immune system begins to attack the cells lining the joints, creating swelling, stiffness, pain and eventual damage to the joint, cartilage and bone itself.
Methotrexate is a member of a class of therapies called disease-modifying anti-rheumatic drugs or DMARDs, which help to ease symptoms and slow the progress of the disease.
A spokesman for Arthritis Research UK commented that folic acid was often recommended to be taken with methotrexate to reduce the side-effects, adding that the study could have implication for future dosage levels of folic acid prescribed.