title: The effects of leucovorin (folinic acid) on methotrexate therapy in rheumatoid arthritis patients.
abstract: High-dose leucovorin (folinic acid) supplementation was tested in a prospective, unblinded manner for 4 weeks in 7 rheumatoid arthritis patients who were being treated successfully with low-dose methotrexate (MTX). Nausea caused by MTX disappeared; however, the underlying rheumatic disease worsened in all patients. Subjective clinical assessment, Ritchie articular index, grip strength, erythrocyte sedimentation rate, and levels of C-reactive protein showed statistically significant deterioration. All these parameters improved after the leucovorin was stopped. This is the first direct clinical evidence implying folate antagonism in the action of low-dose MTX therapy in rheumatoid arthritis patients.
authors.affiliation: Department of Rheumatology, Ichilov Hospital, Tel Aviv Medical Center, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Tishler
authors.forename: D
authors.initials: D
authors.lastname: Caspi
authors.forename: B
authors.initials: B
authors.lastname: Fishel
authors.forename: M
authors.initials: M
authors.lastname: Yaron
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006801:Humans; D002955:Leucovorin / Q000009:adverse effects / Q000627:therapeutic use*; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged
chemical_list: D002955:Leucovorin; D008727:Methotrexate