title: Folate supplementation reduces the side effects of methotrexate therapy for psoriasis.
abstract: BACKGROUND
  Methotrexate (MTX) is an effective treatment option for patients with moderate-to-severe psoriasis. As psoriasis is an incurable disease, the goal of the MTX treatment is to suppress psoriasis, achieving long-term remissions with minimal treatment-related adverse events (AEs).
  
  
  METHODS
  Supplementation with folate - either folic acid (FA) or folinic acid - may reduce the side effects of MTX therapy. There are no consistent, evidence-based guidelines for folate supplementation in this clinical setting. We present data concerning the impact of folic supplementation on the safety and efficacy of MTX therapy for psoriasis. An extensive search (1960 - March 2014) identified few studies addressing with just one randomized controlled trial (RCT) and some case series. This meager yield underlines the need for further studies, especially RCTs, in this group of patients.
  
  
  CONCLUSIONS
  FA may be effective in diminishing the severity of AEs in patients with psoriasis treated with MTX and should be recommended. Supplementation with too high doses of FA may influence the efficacy of treatment.
authors: Wroclaw Medical University, Department of Dermatology, Venereology and Allergology , Chalubinskiego 1, 50-368 Wroclaw , Poland.
authors: Wojciech
authors: W
authors: Baran
authors: Aleksandra
authors: A
authors: Batycka-Baran
authors: Magdalena
authors: M
authors: Zychowska
authors: Andrzej
authors: A
authors: Bieniek
authors: Jacek C
authors: JC
authors: Szepietowski
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005492:Folic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000627:therapeutic use*; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy / Q000473:pathology; D012720:Severity of Illness Index; D014803:Vitamin B Complex / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D018501:Antirheumatic Agents; D014803:Vitamin B Complex; D005492:Folic Acid; D002955:Leucovorin; D008727:Methotrexate
keywords: folic acid supplementation; methotrexate; psoriasis