The efficacy and safety of leflunomide therapy in lupus nephritis by repeat kidney biopsy.

To evaluate the clinical and pathological efficacy, and safety of leflunomide as a new immunosuppressive medicine in lupus nephritis (LN). A total of 31 patients were all determined as LN by kidney biopsy. SLE disease activity index (SLEDAI), clinical and immunological tests of these patients were performed. Meanwhile, the pathological presentation and LN activity of before and after leflunomide therapy were evaluated by repeat biopsy. The patients of LN usually have a bit response by the first or second month visit and have a good response by the third month visit after leflunomide therapy. One year later SLEDAI scores of all patients were significantly improved and 13 patients of them were transformed from complex pathological types to simple types (the transformed ratio was 41.9%). For the other patients not transformed, the pathological presentation took a favorable turn, the pathological active index (AI) of LN were significantly improved. There was not anyone relapsed or aggravated. The side effects of leflunomide were less and mild, and could be improved by symptomatic management with or without decreasing dosage. The clinical and pathological activity of LN can be apparently inhibited and the relapse can be prevented through leflunomide therapy. The side effects of leflunomide are mild and transient. Leflunomide is now a new ideal immunosuppressive medicine in the therapy of LN.