Hyperhomocysteinemia in rheumatoid arthritis: influence of methotrexate treatment and folic acid supplementation.
OBJECTIVE
To examine the effect of methotrexate (MTX) and folic acid supplementation on the homocysteine level in patients with rheumatoid arthritis (RA).


METHODS
A cross sectional study was performed in 81 patients with RA, comprising a standardized clinical interview, an examination, and a blood specimen test.


RESULTS
P-homocysteine tended to be lower in 41 patients receiving MTX, compared with 40 patients not receiving MTX. Of the MTX treated patients, 76% received folic acid supplementation. Multivariate analysis revealed a statistically significant association between P-homocysteine and P-creatinine (p < 0.001), and disease activity/progression measured by the Health Assessment Questionnaire score (p < 0.001). There was a tendency to negative association between P-homocys-teine and folic acid supplementation.


CONCLUSIONS
P-homocysteine in patients with RA receiving MTX and folic acid supplementation did not differ significantly from P-homocysteine in RA patients receiving other types of treatment.
Department of Rheumatology, University Hospital of Aalborg, Denmark.
Ole Kudsk
OK
Jensen
Claus
C
Rasmussen
Frank
F
Mollerup
Peder Bjerg
PB
Christensen
Henrik
H
Hansen
Suzanne
S
Ekelund
Ane Marie
AM
Thulstrup
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004185:Disability Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D005493:Folic Acid Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D005494:Folic Acid Deficiency / Q000097:blood / Q000139:chemically induced / Q000517:prevention & control; D006304:Health Status; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D005493:Folic Acid Antagonists; D006710:Homocysteine; D005492:Folic Acid; D008727:Methotrexate