Folic Acid and Methotrexate in Rheumatoid Arthritis
Authors: Sarah L. Morgan
Journal: Annals of Internal Medicine (1996)

Letters1 January 1996Folic Acid and Methotrexate in Rheumatoid ArthritisSarah L. Morgan, MD, RD, Jeannette Y. Lee, PhD, and Graciela S. Alarcon, MD, MPHSarah L. Morgan, MD, RDUniversity of Alabama at Birmingham; Birmingham, AL 35294Search for more papers by this author, Jeannette Y. Lee, PhDUniversity of Alabama at Birmingham; Birmingham, AL 35294Search for more papers by this author, and Graciela S. Alarcon, MD, MPHUniversity of Alabama at Birmingham; Birmingham, AL 35294Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-1_Part_1-199601010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Cooper questions the statistical validity of our conclusions regarding the effect of folic acid supplementation on the efficacy of methotrexate. Our sample size and power calculations were based on the toxicity data, which were the primary outcome of the study. We could not show any difference in the efficacy of methotrexate among the three treatment groups. Although Dr. Cooper is correct that we might not have had adequate power to show the existence of such differences, no trend suggested a dose response in patients receiving the higher dose of folic acid and experiencing less efficacy from methotrexate ...References1. Hine RJ, Alarcon GS, Koopman WJ, Morgan SL, Baggott JE, Clegg DO, et al. Serum folate (FA) levels of rheumatoid arthritis (RA) patients treated with methotrexate (MTX) or other disease-modifying antirheumatic drugs (DMARDSs). Arthritis Rheum. 1990; 33:S60. Google Scholar2. Morgan SL, Baggott JE, Vaughn WH, Young PK, Austin JV, Krumdieck CL, et al. The effect of folic acid supplementation on the toxicity of low-dose methotrexate treatment of rheumatoid arthritis. Arthritis Rheum. 1990; 33:9-18. Google Scholar3. Felson DT, Anderson JJ, Boers M, Bombardier C, Chernoff M, Fired B, et al. The American College of Rheumatology preliminary core set of disease activity measures for rheumatoid arthritis clinical trials. Arthritis Rheum. 1993; 36:729-40. Google Scholar4. GS, Tracy IC, Blackburn WD. Methotrexate in rheumatoid arthritis. Toxic effects as the major factor in limiting long-term treatment. Arthritis Rheum. 1989; 32:671-6. Google Scholar5. Shiroky JB, Neville C, Esdaile JM, Choquette D, Zummer M, Hazeltine M, et al. Low-dose methotrexate with leucovorin (folinic acid) in the management of rheumatoid arthritis. Results of a multicenter randomized, double-blind, placebo controlled trial. Arthritis Rheum. 1993; 36:795-803. Google Scholar Author, Article, and Disclosure InformationAuthors: Sarah L. Morgan, MD, RD; Jeannette Y. Lee, PhD; Graciela S. Alarcon, MD, MPHAffiliations: University of Alabama at Birmingham; Birmingham, AL 35294 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMethotrexate in rheumatoid arthritis: An updatewith focus on mechanisms involved in toxicity 1 January 1996Volume 124, Issue 1_Part_1Page: 74KeywordsFolic acidForecastingInflammationMean corpuscular volumeMethotrexateRheumatoid arthritisRheumatologyRisk managementStatistical dataToxicity ePublished: 15 August 2000 Issue Published: 1 January 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...