The effects of low-dose weekly folate supplementation versus high-dose daily folate

Abstract

Objectives: There is no consensus on the dosage of folic acid required for the prevention of methotrexate (MTX) toxicity in rheumatoid arthritis (RA). The aim of the study was to assess the effects of low-dose weekly folate versus high-dose daily folate on prevention of MTX toxicity in RA patients.

Materials and Methods: Randomized controlled study of rheumatoid arthritis patients who were treated at Department of Rheumatology in Gazi University between October 2009 and February 2010. Thirty-eight RA patients were received 10 mg/week MTX and 5-10 mg/day prednisolon were randomly allocated to receive 5 mg/week folate or 2.5 mg six days/week folate. All patients were evaluated for complete blood cell count, liver function tests, alopecia, stomatitis and gastrointestinal symptoms before and six months after the treatment.

Results: There were no significant differences in the development of stomatitis, alopecia, gastrointestinal symptoms, anemia, leukopenia, erythropenia, thrombocytopenia, elevated liver function tests between the groups at sixth month.

Conclusion: Our results support that 5 mg folate supplementation once a week is adequate in RA patients.

Keywords

• Methotrexate; rheumatoid arthritis; folate supplementation

Romatoid Artritli Hastalarda Metotreksat Toksisitesini Önlemede Yüksek Doz Günlük Folat Desteğine Karşın Düşük Doz Haftalık Folat Desteğinin Etkileri

Öz

Amaç: Romatoid artritte metotreksat toksisitesinin önlenmesinde gerekli folik asit  dozu ile ilgili ortak bir görüş yoktur. Bu çalışmanın amacı romatoid artritli hastalarda metotreksat toksisitesinin önlenmesinde yüksek doz günlük folat  kullanımına karşın düşük doz haftalık folat kullanımının etkilerini değerlendirmekti.            

Materyal ve Metot: Ekim 2009 ile Şubat 2010 tarihleri arasında Gazi Üniversitesi Romatoloji Bölümü'nde tedavi edilen romatoid artritli  hastalarda yapılan randomize kontrollü bir çalışma. 10 mg/hafta ve 5-10 mg/gün prednisolon kullanan 34 romatoid artritli hastaya randomize şekilde 5mg/hafta folat veya 2.5 mg 6 gün/hafta folat verildi. Hastaların tam kan sayımları, karaciğer fonksiyon testleri, alopesi, stomatit ve gastrointestinal semptomları tedaviden önce ve tedaviden 6 ay sonra değerlendirildi.

Bulgular: Tedavinin 6. ayında stomatit, alopesi, gastrointestinal semptomlar, anemi, lökopeni, eritropeni, trombositopeni, eleve karaciğer fonksiyon testleri açısından gruplar arasında fark yoktu.

Sonuç: Sonuçlarımız haftalık 5 mg folat desteğinin romatoid artritli hastalarda yeterli olduğunu desteklemektedir.

Anahtar Kelimeler

• Metotreksat, romatoid artrit, folat desteği

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