The use of folic acid supplementation in psoriasis patients receiving methotrexate: a survey in the United Kingdom

There is little literature on the use of folic acid supplementation in psor iasis patients being treated with methotrexate. Under the auspices of the B ritish Association of Dermatologists we surveyed, using a questionnaire, th e use of folic acid supplementation with methotrexate therapy for psoriasis by dermatologists in the UK. Six-hundred and fifteen questionnaires were s ent and 153 responses were received (25%), One-hundred and fourteen of the responders (75%) used folic acid supplementation with methotrexate in psori asis patients, Thirty (26%) of these used folic acid supplementation in all patients taking methotrexate and 84 (74%) used folic acid only under certa in circumstances, the most common of which was an elevated erythrocyte mean corpuscular volume, Forty-six per cent of respondents believed that folic acid supplementation reduced nausea and 60% believed that folic acid did no t interfere with the efficacy of methotrexate. A wide variety of dosing reg imens were used for folic acid supplementation. In the absence of guideline s and controlled trials, there is great variation in the indication for use , dosing regimens used and beliefs regarding methotrexate supplementation f or psoriasis, Randomized controlled trials are necessary to address these q uestions.