Question
My husband has been on Enbrel weekly and was doing well. Last year, he had problems in one hip (which turned out to be a hip labral tear unrelated to RA which was subsequently debrided successfully with arthroscopic hip surgery). Before the rheumatologist knew the pain was not related to RA, he put him on 10mg methotrexate weekly in addition to the Enbrel. Should my husband try and get off the 1mg/daily of Folate & the methotrexate given the recent negative press about too much folate encouraging pre cancers to develop? I read that taking any of the biologics can be a risk for developing cancer. Thank you for your advice.
Answer
Hi Lois,
Those are good questions. My understanding of the folic acid issue is that an overabundance (taking more than is generally needed by the body) raised the risk of prostate cancer (other types of cancer were not reported on). But, in men who took the normal amounts of folic acid, the risk was actually reduced. Methotrexate interferes with production of folic acid, so taking folate replacement is important when taking MTX. The dose recommended (1 mg/day) in patients on MTX is meant to simulate normal levels in patients not on MTX, but we don’t routinely measure the blood levels of folic acid. You should discuss your questions with your rheumatologist as each individual is different, and he may need MTX for other joint involvement (or not !!).
