PMID- 36228310
OWN - NLM
STAT- MEDLINE
DCOM- 20221017
LR  - 20221120
IS  - 1465-3664 (Electronic)
IS  - 0142-6338 (Linking)
VI  - 68
IP  - 6
DP  - 2022 Oct 6
TI  - Optimum dose of oral folic acid supplementation in transfusion-dependent 
      thalassemia: a randomized controlled trial.
LID - fmac087 [pii]
LID - 10.1093/tropej/fmac087 [doi]
AB  - AIM AND OBJECTIVES: We compared the effect of different doses of oral folic acid 
      (FA) supplementation (5 mg/day vs. 2.5 mg/day vs. 5 mg/week) on the proportion of 
      children with folate excess (serum folate >20 ng/ml) and plasma homocysteine 
      (Hcys) excess (>15 micromol/l) in transfusion-dependent thalassemia (TDT). 
      MATERIALS AND METHODS: Children with TDT aged 5-18 years received oral FA in 
      doses of 5 mg/day (Group 1), 2.5 mg/day (Group 2) and 5 mg/week (Group 3) for 
      9 months, after a wash-off period of 8 weeks. Folate levels (Serum and RBC) and 
      plasma Hcys levels were measured after the therapy. RESULTS: Ninety children were 
      randomized to receive one of the three interventions (30 per group). After 
      wash-off period, the median serum folate levels were significantly lower and five 
      children developed folate deficiency; the median [interquartile range (IQR)] 
      serum folate levels (ng/dl) were comparable in the three groups [Group 1: 6.5 
      (3.3-14.2), Group 2: 5.1 (2.6-10.5) and Group 3: 4.8 (3.4-10.0)]. After 9 months 
      of intervention, the median (IQR) serum folate levels (ng/ml) were comparable in 
      all participants [Group 1: 18.0 (6.5-28), Group 2: 13.5 (6.4-24.5) and Group 3: 
      9.7 (5.3-22.5); p = 0.11]. Proportion of children with serum folate excess was 
      40%, 26.7% and 26.7% in Group 1, Group 2 and Group 3 (p = 0.48). Proportion of 
      children with RBC folate excess was 92%, 86.7% and 86.7% in Group 1, Group 2 and 
      Group 3 (p = 0.79). Hyperhomocysteinemia was seen in eight children with no 
      significant difference between median Hcys levels in the groups (p = 0.75). 
      CONCLUSION: Folic acid supplementation is recommended in TDT with 5 mg weekly 
      dose being adequate.
CI  - (c) The Author(s) [2022]. Published by Oxford University Press. All rights 
      reserved. For permissions, please email: journals.permissions@oup.com.
FAU - Agrawal, Titiksha
AU  - Agrawal T
AUID- ORCID: 0000-0003-3538-8757
AD  - Department of Pediatrics, University College of Medical Sciences, Delhi 110095, 
      India.
FAU - Dewan, Pooja
AU  - Dewan P
AUID- ORCID: 0000-0002-7373-5679
AD  - Department of Pediatrics, University College of Medical Sciences, Delhi 110095, 
      India.
FAU - Gomber, Sunil
AU  - Gomber S
AD  - Department of Pediatrics, University College of Medical Sciences, Delhi 110095, 
      India.
FAU - Agarwal, Rachna
AU  - Agarwal R
AD  - Department of Neurochemistry, Institute of Human Behaviour & Allied Sciences 
      (IHBAS), Delhi 110095, India.
FAU - Sharma, Sangeeta
AU  - Sharma S
AD  - Department of Neuropsychopharmacology, Institute of Human Behaviour & Allied 
      Sciences (IHBAS), Delhi 110095, India.
FAU - Kotru, Mrinalini
AU  - Kotru M
AD  - Department of Pathology, University College of Medical Sciences, Delhi 110095, 
      India.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Trop Pediatr
JT  - Journal of tropical pediatrics
JID - 8010948
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - 935E97BOY8 (Folic Acid)
SB  - IM
MH  - Child
MH  - Dietary Supplements
MH  - *Folic Acid
MH  - Homocysteine
MH  - Humans
MH  - *Thalassemia/drug therapy
OTO - NOTNLM
OT  - child
OT  - folate
OT  - hemolytic anemia
OT  - homocysteine
EDAT- 2022/10/14 06:00
MHDA- 2022/10/18 06:00
CRDT- 2022/10/13 17:12
PHST- 2022/10/13 17:12 [entrez]
PHST- 2022/10/14 06:00 [pubmed]
PHST- 2022/10/18 06:00 [medline]
AID - 6760805 [pii]
AID - 10.1093/tropej/fmac087 [doi]
PST - ppublish
SO  - J Trop Pediatr. 2022 Oct 6;68(6):fmac087. doi: 10.1093/tropej/fmac087.