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Methotrexate catabolism to 7-hydroxymethotrexate in rheumatoid arthritis alters drug efficacy and retention and is reduced by folic acid supplementation
Arthritis & Rheumatism, 08/06/09
Baggott JE et al. – The findings of a non–normal distribution of 7–OH–MTX excretion suggest that there are at least 2 phenotypes for this catabolism. Decreased 7–OH–MTX formation suggests folic acid inhibition of AO and a better clinical response, while increased 7–OH–MTX formation may interfere with MTX polyglutamylation and binding to enzymes and, therefore, may increase MTX excretion and decrease MTX retention and efficacy in vivo.
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