Efficacy of formic acid in combination with cDMARDs in rheumatoid arthritis.

Abstract

The immune system of the body mistakenly targets its own joints in rheumatoid arthritis (RA), a chronic autoimmune disease that causes pain, inflammation, and damage. The complexity of RA often requires the simultaneous use of several different management strategies. This study examines the potential enhancement of conventional RA treatments, specifically conventional Disease-Modifying Anti-Rheumatic Drugs (cDMARDs), by the addition of formic acid, a naturally occurring substance that may possess anti-inflammatory properties. A total of 90 children diagnosed with rheumatoid arthritis were examined at our hospital from 2020 to 2022. We segregated them into two cohorts, each consisting of 45 children. One cohort was administered conventional rheumatoid arthritis (RA) treatments, referred to as cDMARDs, which specifically included methotrexate and leflunomide. The other group was administered the standard treatments in addition to a low dosage of a specialized medication known as all-trans retinoic acid. We conducted follow-up assessments on the children at 6 months and 1-year post-treatment. We sought to evaluate the efficacy of the treatments by assessing the subjective reports of the children and their physicians, analyzing the outcomes of medical examinations, and examining diagnostic images, such as X-rays. Furthermore, we took measures to ensure the safety of the treatments. Among the cohort exclusively administered cDMARDs, approximately 26.7% exhibited significant improvement, 24.4% demonstrated moderate improvement, and 6.7% displayed minor improvement after a duration of 6 months. Approximately 57.8% of the children in this group experienced positive outcomes as a result of the treatment. The group that received retinoic acid also demonstrated superior outcomes. Approximately one-third (33.3%) of the participants demonstrated significant improvement, while another one-third showed moderate improvement. Additionally, 11.1% of the participants displayed minor improvement after a period of six months. Upon comparing the two groups, it was observed that the group receiving retinoic acid demonstrated a significantly superior outcome (p<0.05). Overall, the incorporation of all-trans retinoic acid alongside conventional treatments for children with RA appears to enhance their efficacy.