Folic Acid Keeps RA Patients on Methotrexate

Dutch investigators have discovered that approximately two thirds of patients with rheumatoid arthritis (RA) taking methotrexate can continue using the drug for at least 5 years. Also, adding folic acid and prednisolone to treatment regimens seems to alleviate the side effects of methotrexate and therefore increases the chances that patients will continue taking the drug.

Methotrexate is the standard drug used to ease the symptoms and to slow joint deterioration. Reports suggest that the drug increases life expectancy in patients with autoimmune diseases.Yet, ~30% of patients stop treatment early as a result of toxicity (manifested as stomach upset or abnormal liver enzyme test results) or because the drug is ineffective.

The researchers reached their conclusions after analyzing data to learn what factors influenced the chances that patients would continue using methotrexate. In a study (reported recently in the Journal of Rheumatology) of 1072 methotrexate episodes in 1022 RA patients, 64% of patients were still taking methotrexate after 5 years, and 50% had continued as long as 9 years. Also, twice as many patients who took folic acid were still using methotrexate after 5 years.