The effects of leucovorin (folinic acid) on methotrexate therapy in rheumatoid arthritis patients.
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.
Tishler
M
M
Department of Rheumatology, Ichilov Hospital, Tel Aviv Medical Center, Israel.
Caspi
D
D
Fishel
B
B
Yaron
M
M
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
D002955:Leucovorin; D008727:Methotrexate