Homocysteine in patients with rheumatoid arthritis in relation to inflammation and B‐vitamin treatment

Abstract

Objectives: To investigate the effects of treatment with B vitamins on homocysteine (Hcy) levels in patients with RA, and to analyse the relationship between Hcy levels and inflammatory variables, and/or MTX treatment.

Methods: Sixty‐two patients with RA and levels of Hcy ≥12 μmol/L were randomized to receive placebo or a combination of vitamins B6, B12 and folic acid. The patients were treated and evaluated in a double‐blind manner over 12 months.

Results: The Hcy level decreased significantly in the B‐vitamin treated patients compared with the placebo treated patients. In a simple regression model, the Hcy level at inclusion was associated with IL‐2sRα. In a multiple regression model there was an association between the alteration in Hcy level over 0–12 months and MTX treatment, as well as the alteration in CRP, adjusted for B‐vitamin treatment.

Conclusions: In patients with RA, Hcy levels can be reduced by treatment with B‐vitamins. The Hcy levels were related to markers of inflammation and MTX treatment.

• homocysteine
• rheumatoid arthritis
• cardiovascular disease
• inflammation
• methotrexate
• vitamin B12
• vitamin B6
• folic acid