HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Arabelovic, S. Articles by Roubenoff, R. Search for Related Content PubMed PubMed Citation Articles by Arabelovic, S. Articles by Roubenoff, R.

Preliminary Evidence Shows That Folic Acid Fortification of the Food Supply Is Associated with Higher Methotrexate Dosing in Patients with Rheumatoid Arthritis

US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University (S.A., G.S., G.E.D., P.F.J., J.S. I.H.R., R.R.)
Division of Rheumatology/Immunology, Arthritis Treatment Center, Tufts-New England Medical Center (S.A., R.R.), Boston, Massachusetts

Address reprint requests to: R. Roubenoff, Nutrition, Exercise, Physiology, and Sarcopenia Laboratory, USDA HNRCA, 711 Washington St., Boston, MA 02111. E-mail: ronenn.roubenoff{at}biogenidec.com

Background: Fortification of the diet with folate has been used in the United States since 1997 to prevent neural tube defects in newborn babies. However, an increase in dietary folate intake could theoretically reduce the effectiveness of the anti-folate medication, methotrexate (MTX) in treating rheumatoid arthritis (RA) and other inflammatory diseases.

Objective: To investigate whether dietary fortification with folic acid interferes with MTX function in patients with RA.

Methods: We computed MTX dose per patient per year for the years 1988 to 1999 and plotted these against time, comparing the overall mean MTX dose before and after 1997, when dietary fortification with folic acid was instituted in the USA. Thirty-six subjects met eligibility criteria.

Results: Mean annual MTX dose was stable between 1988 and 1996 (12.4 ± 4.0mg), but then rose linearly from 1997 to 1999 (16.6 ± 5.1 mg, p < 0.001).

Conclusions: This preliminary study suggests that folic acid supplementation may contribute to higher MTX dosing in patients with RA.

This article has been cited by other articles:

				J. E Baggott and S. L Morgan Folic acid supplements are good (not bad) for rheumatoid arthritis patients treated with low-dose methotrexate Am. J. Clinical Nutrition, August 1, 2008; 88(2): 479 - 480. [Full Text] [PDF]

				A D. Smith and H. Refsum Reply to E Baggott and SL Morgan Am. J. Clinical Nutrition, August 1, 2008; 88(2): 480 - 480. [Full Text] [PDF]