Similar effect of co-administration of methotrexate and folic acid for the treatment of arthritis compared to separate administration

Rheumatology (Oxford). 2023 Apr 3;62(4):1706-1710. doi: 10.1093/rheumatology/keac579.

Abstract

Objectives: MTX is the recommended first-line treatment for RA associated with folic acid (FA) to reduce side effects related to MTX. Here, we proposed to test a co-administration of MTX with FA in the rat adjuvant-induced arthritis (AIA) on efficacy.

Material and methods: AIA was induced in female Lewis rats and treated with MTX in three groups. The first group of rats received only MTX (n = 13), whereas the second received MTX and FA on the same day (n = 14). The third group received FA one day after MTX (n = 14). Arthritic index (AI), ankle circumference (AC), ankle microcomputed tomography, and blood tests assessed arthritis severity and MTX tolerance.

Results: AI and AC were similar in MTX groups at various time points. Bone erosion and bone loss parameters were similar in all groups. MTX-PG1 was found at similar levels in various MTX groups and correlated negatively with arthritis severity. Finally, haematology and metabolic parameters were found at a similar level in MTX groups.

Conclusion: Co-administration of MTX with FA on the same day did not reduce efficacy compared with FA application one day after MTX. Thus, co-administration of MTX and FA could be more convenient and improve compliance in patients.

Keywords: MTX; arthritis; co-administration; efficacy; folic acid.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Arthritis, Experimental* / metabolism
  • Female
  • Folic Acid / therapeutic use
  • Methotrexate* / therapeutic use
  • Rats
  • Rats, Inbred Lew
  • X-Ray Microtomography

Substances

  • Methotrexate
  • Folic Acid