Abstract
A double blind, placebo controlled trial examined the effects of folinic acid on the efficacy and toxicity of methotrexate in 27 patients with rheumatoid arthritis. Clinical and laboratory indices of disease activity worsened significantly in the 13 patients treated with folinic acid after four weeks of treatment, but not in the 14 patients treated with placebo. Exacerbation of rheumatoid arthritis led to withdrawal of the test drug in seven of the patients treated with folinic acid but in none of those treated with placebo. It is concluded that excerbation of rheumatoid arthritis is likely when folinic acid is given shortly after the weekly dose of methotrexate.
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- Arnett F. C., Edworthy S. M., Bloch D. A., McShane D. J., Fries J. F., Cooper N. S., Healey L. A., Kaplan S. R., Liang M. H., Luthra H. S. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988 Mar;31(3):315–324. doi: 10.1002/art.1780310302. [DOI] [PubMed] [Google Scholar]
- Baker R. I., Manoharan A. Cytopenias induced by methotrexate in inflammatory arthritis. Aust N Z J Med. 1989 Dec;19(6):747–748. doi: 10.1111/j.1445-5994.1989.tb00356.x. [DOI] [PubMed] [Google Scholar]
- Goldman I. D., Matherly L. H. Biochemical factors in the selectivity of leucovorin rescue: selective inhibition of leucovorin reactivation of dihydrofolate reductase and leucovorin utilization in purine and pyrimidine biosynthesis by methotrexate and dihydrofolate polyglutamates. NCI Monogr. 1987;(5):17–26. [PubMed] [Google Scholar]
- Hanrahan P. S., Russell A. S. Concurrent use of folinic acid and methotrexate in rheumatoid arthritis. J Rheumatol. 1988 Jul;15(7):1078–1080. [PubMed] [Google Scholar]
- Polk J. R. Beneficial effects of leucovorin after methotrexate treatment in rheumatoid arthritis: a case report. Arthritis Rheum. 1988 Dec;31(12):1587–1588. doi: 10.1002/art.1780311223. [DOI] [PubMed] [Google Scholar]
- Tishler M., Caspi D., Fishel B., Yaron M. The effects of leucovorin (folinic acid) on methotrexate therapy in rheumatoid arthritis patients. Arthritis Rheum. 1988 Jul;31(7):906–908. doi: 10.1002/art.1780310712. [DOI] [PubMed] [Google Scholar]