@entity1501 supplementation and @entity1499 treatment in XXXX : a review.

@entity1501 @entity4181 @entity1 @entity1255 @entity1500 @entity65 @entity26457 @entity1499 @entity309
OBJECTIVES: The @entity1501 antagonist @entity1499 ( @entity1500 ) has become established as the most commonly used disease-modifying anti-rheumatic drug (DMARD) in the treatment of @entity309 ( @entity309 ) but is commonly discontinued due to adverse effects. Adverse effects are thought to be mediated via @entity1501 antagonism. In this paper we summarize the current data on the use of @entity26457 as a supplement to @entity1500 use in @entity309 for the prevention of adverse effects and as a potential modulator of cardiovascular risk, and propose guidelines for standard practice. METHODS: A Medline search was performed using the search terms " @entity1499 ", " @entity1501 ", " @entity4181 ", " @entity1501 " and " @entity1255 ". Literature relevant to the use of @entity26457 as a supplement to @entity1500 in the treatment of @entity309 was reviewed and other papers referred to as references were explored. RESULTS: The use of supplemental @entity26457 , including folic and @entity4181 , in @entity309 @entity1 treated with @entity1500 has been shown to improve continuation rates by reducing the incidence of liver function test abnormalities and gastrointestinal intolerance. @entity1501 supplements do not appear to significantly reduce the effectiveness of @entity1500 in the treatment of @entity309 . Furthermore, supplemental @entity1501 offsets the elevation in plasma @entity1255 associated with the use of @entity1500 . This may in turn reduce the risk of @entity65 , which is over-represented amongst @entity1 with @entity309 , and for which hyperhomocysteinaemia is now recognized as an independent risk factor. CONCLUSIONS: We propose that @entity1501 supplements be prescribed routinely to all @entity1 receiving @entity1500 for the treatment of @entity309 . We recommend a pragmatic dosing schedule of 5 mg of oral @entity1501 given on the morning following the day of @entity1500 administration.
