Qiaoding Dai1,2, Liping Xu1, Xiali Yu1. 1. Department of Rheumatology and Immunology, First Affiliated Hospital of Zhejiang, Chinese Medical University, Hangzhou, China. 2. The First Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, China.
Abstract
AIM: To systematically assess the clinical efficacy and safety of leflunomide for treating psoriatic arthritis (PsA). METHODS: PubMed, Embase, and Cochrane Library databases were searched until 1 January, 2018, to include relevant studies in this single-arm meta-analysis. Psoriasis improvement was evaluated using Psoriasis Area and Severity Index (PASI) scores. The primary outcome in patients was assessed using the Psoriatic Arthritis Response Criteria (PsARC). Other effectiveness evaluations included those of adverse events, quality of life including functional status (Health Assessment Questionnaire [HAQ] total score), and a quality-of-life instrument for dermatologic diseases (Dermatology Life Quality Index [DLQI] total score). RESULTS: A total of 6 studies were included. After leflunomide treatment, 48% of the patients experienced a reduction of ≥50% based on PASI scores (95% confidence interval [CI]: 0.22-0.73). PASI 75 improvement was observed among 25% of the patients (95% CI: 0.11-0.38). The primary effectiveness analysis revealed that 15% of the patients (95% CI: 0.07-0.26) discontinued leflunomide treatment. Further, 77% of the patients (95% CI: 0.59-0.92) achieved a PsARC response. Adverse events occurred in 38% of the patients (95% CI: 0.04-0.71). The mean ± SD percentage PASI improvement was -4.88 (95% CI: -8.92, -0.85). Moreover, DLQI and HAQ were -2.02 (95% CI: -3.01, -1.03) and -0.19 (95% CI: -0.29, -0.09), respectively. CONCLUSIONS: Leflunomide is an effective and well-tolerated treatment for PsA, and would be a safe and convenient option.
AIM: To systematically assess the clinical efficacy and safety of leflunomide for treating psoriatic arthritis (PsA). METHODS: PubMed, Embase, and Cochrane Library databases were searched until 1 January, 2018, to include relevant studies in this single-arm meta-analysis. Psoriasis improvement was evaluated using Psoriasis Area and Severity Index (PASI) scores. The primary outcome in patients was assessed using the Psoriatic Arthritis Response Criteria (PsARC). Other effectiveness evaluations included those of adverse events, quality of life including functional status (Health Assessment Questionnaire [HAQ] total score), and a quality-of-life instrument for dermatologic diseases (Dermatology Life Quality Index [DLQI] total score). RESULTS: A total of 6 studies were included. After leflunomide treatment, 48% of the patients experienced a reduction of ≥50% based on PASI scores (95% confidence interval [CI]: 0.22-0.73). PASI 75 improvement was observed among 25% of the patients (95% CI: 0.11-0.38). The primary effectiveness analysis revealed that 15% of the patients (95% CI: 0.07-0.26) discontinued leflunomide treatment. Further, 77% of the patients (95% CI: 0.59-0.92) achieved a PsARC response. Adverse events occurred in 38% of the patients (95% CI: 0.04-0.71). The mean ± SD percentage PASI improvement was -4.88 (95% CI: -8.92, -0.85). Moreover, DLQI and HAQ were -2.02 (95% CI: -3.01, -1.03) and -0.19 (95% CI: -0.29, -0.09), respectively. CONCLUSIONS:Leflunomide is an effective and well-tolerated treatment for PsA, and would be a safe and convenient option.
Authors: João F S Rodrigues; Liziane C M da Silva; Leia Cardoso-Sousa; Douglas Carvalho Caixeta; Debora D Lückemeyer; Alisson S Henrique; Jaqueline P Pontes; Lycia M G da Silva; Juliana S S Macedo; Pedro S Carvalho Júnior; Cristiane Silva E Silva; Mahiba M R S Martins; Valério Monteiro-Neto; Marcos A G Grisotto; Anita M R Fernandes; Juliano Ferreira; João B Calixto; Robinson Sabino-Silva; Elizabeth S Fernandes Journal: Pharmaceuticals (Basel) Date: 2021-01-29
Authors: Elena Generali; Greta Carrara; Alessandra Bortoluzzi; Maria De Santis; Angela Ceribelli; Carlo A Scirè; Carlo Selmi Journal: J Transl Autoimmun Date: 2021-08-16
Authors: Michelle L M Mulder; Johanna E Vriezekolk; Nathan den Broeder; Elien A M Mahler; Philip S Helliwell; Frank H J van den Hoogen; Alfons A den Broeder; Mark H Wenink Journal: Trials Date: 2020-02-10 Impact factor: 2.279