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Abstract
Background: Rheumatoid arthritis is a chronic inflammatory joint disease,
indicated by a symmetrical erosive synovitis. Disease-modifying anti-rheumatic
drugs (DMARDs) are known to interfere with signs and symptoms of RA, improve
physical function and therefore increase patient productivity. Methotrexate is an
anchor drug for rheumatoid arthritis patients, however, its related mechanism of
action with folate deficiency resulting in some side effects, including
gastrointestinal and liver toxicity. Folic acid supplementation may reduce these
side effects. Method: A search was conducted on Pubmed, Cochrane, EBSCOhost,
and ProQuest. After the selection of title and abstract was done using inclusion
and exclusion criteria, which led to one relevant article. The selected study was
critically appraised for its validity, importance, and applicability. Result: In
rheumatoid arthritis patient receiving methotrexate, there was a statistically
significant reduction in the incidence of abnormal transaminase elevation (RR:
0.19, 95% CI: 0.10-0.36), but the reduction in gastrointestinal side effects did not
reach statistical significance (RR: 0.76, 95% CI: 0.57-1.01) Conclusion: Folic acid
supplementation has an effect in reducing gastrointestinal and liver toxicity as side
effects of methotrexate in rheumatoid arthritis patients.