Doesfolate supplementation makesenseinpatients withrheumatoid arthritis treated with methotrexate

AnnemiekAMEStenger, Pieternella MHoutman,GeorgeAWBruynThepotentialvalueoftheantifolatemethotrexate(N1O-methylaminopterin) in the treatment ofrheumatoid arthritis (RA) was first recognisedin 1951.' Thelow dose drug administration individeddoses 12 hoursapartwasdevelopedforthe treatment ofpatients with psoriasis, basedonpropertiesofpsoriaticepithelial cells andthebiologicalactionofmethotrexateonthesecells.2To date its mode of action has not been wellestablished.3 It is generally believed that lowdose weekly pulses of methotrexate are notmarkedlyimmunosuppressive. Thisis basedonthe