Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

207 questions · 223 findings · 29 reviews · Headline outcomes only

No studies found 43 · 19.3%GRADE not reported 14 · 6.3%Very low 39 · 17.5%Low 67 · 30%Moderate 54 · 24.2%High 6 · 2.7%

Folinic acid vs placebo

Liver toxicity (incidence of transaminase elevation) · Patients receiving methotrexate for rheumatoid arthritis

Folinic acid probably leads to lower liver toxicity (incidence of transaminase elevation) compared with placebo (moderate certainty).

1 finding from 1 review

Folic or folinic acid (any) vs placebo

Stomatitis / mouth sores (incidence) · Patients receiving methotrexate for rheumatoid arthritis

Folic or folinic acid (any) showed no clear difference in stomatitis / mouth sores (incidence) compared with placebo (moderate certainty).

1 finding from 1 review

Folic or folinic acid (any) vs placebo

Liver toxicity (incidence of transaminase elevation) · Patients receiving methotrexate for rheumatoid arthritis

Folic or folinic acid (any) probably leads to lower liver toxicity (incidence of transaminase elevation) compared with placebo (moderate certainty).

1 finding from 1 review

Folic or folinic acid (any) vs placebo

Haematological disorders (neutropenia, etc) · Patients receiving methotrexate for rheumatoid arthritis

Folic or folinic acid (any) showed no clear difference in haematological disorders (neutropenia, etc) compared with placebo (low certainty).

1 finding from 1 review

Summary of findings: Folic acid vs placebo

GI side effects (ie, incidence of nausea, vomiting, abdominal pain) · Patients receiving methotrexate for rheumatoid arthritis

Folic acid showed no clear difference in GI side effects (ie, incidence of nausea, vomiting, abdominal pain) compared with placebo (moderate certainty).

1 finding from 1 review