Literature DB >> 7488280

Safety and effectiveness of leflunomide in the treatment of patients with active rheumatoid arthritis. Results of a randomized, placebo-controlled, phase II study.

V Mladenovic1, Z Domljan, B Rozman, I Jajic, D Mihajlovic, J Dordevic, M Popovic, M Dimitrijevic, M Zivkovic, G Campion.   

Abstract

OBJECTIVE: To assess the safety and effectiveness of leflunomide versus placebo in patients with active rheumatoid arthritis (RA) treated for 6 months.
METHODS: Four hundred two patients were randomly assigned to receive placebo or leflunomide at 5 mg, 10 mg, or 25 mg daily. A washout period of 6-12 weeks from prior second-line therapy was required.
RESULTS: Statistically significant improvement in primary and secondary outcome measures, as well as by responder analyses, occurred in the 10-mg and 25-mg dosage groups compared to placebo. Twenty-one patients (7.0%) in the active treatment groups withdrew due to adverse events (AEs). The incidence of AEs was higher with leflunomide than with placebo. Gastrointestinal symptoms, weight loss, allergic reactions, skin rash, and reversible alopecia were more common in the 10-mg and 25-mg dosage groups. The incidence of infections was similar between the treatment and placebo groups; no opportunistic infections were seen. Transient elevations in liver function studies were noted in a small number of patients.
CONCLUSION: Leflunomide is effective in daily doses of 10 mg and 25 mg in patients with active RA. Improved efficacy at the 25-mg dose was associated with a higher incidence of AEs. Randomized, placebo-controlled trials using daily doses of 10 mg and 20 mg are under way in the US and Europe to confirm these positive results.

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Year:  1995        PMID: 7488280     DOI: 10.1002/art.1780381111

Source DB:  PubMed          Journal:  Arthritis Rheum        ISSN: 0004-3591


  50 in total

1.  A771726, the active metabolite of leflunomide, directly inhibits the activity of cyclo-oxygenase-2 in vitro and in vivo in a substrate-sensitive manner.

Authors:  L C Hamilton; I Vojnovic; T D Warner
Journal:  Br J Pharmacol       Date:  1999-08       Impact factor: 8.739

Review 2.  Update in internal medicine.

Authors:  F López-Jiménez; M Brito; Y W Aude; P Scheinberg; M Kaplan; D A Dixon; N Schneiderman; J F Trejo; L H López-Salazar; E J Ramírez-Barba; R Kalil; C Ortiz; J Goyos; A Buenaño; S Kottiech; G A Lamas
Journal:  Arch Med Res       Date:  2000 Jul-Aug       Impact factor: 2.235

Review 3.  Combination therapy for autoimmune diseases: the rheumatoid arthritis model.

Authors:  N Fathy; D E Furst
Journal:  Springer Semin Immunopathol       Date:  2001

4.  Leflunomide can potentiate the anticoagulant effect of warfarin.

Authors:  V Lim; I Pande
Journal:  BMJ       Date:  2002-12-07

Review 5.  Leflunomide: a review of its use in active rheumatoid arthritis.

Authors:  A Prakash; B Jarvis
Journal:  Drugs       Date:  1999-12       Impact factor: 9.546

6.  [Treatment with leflunomide in rheumatoid arthritis].

Authors:  K Krüger; W Bolten
Journal:  Z Rheumatol       Date:  2005-03       Impact factor: 1.372

7.  Severe hepatotoxicity in a rheumatoid arthritis patient switched from leflunomide to methotrexate.

Authors:  Rachna Gupta; S K Gupta
Journal:  MedGenMed       Date:  2005-09-06

8.  Effectiveness of maintenance therapy with methotrexate compared with leflunomide for patients with RA having achieved disease control with both these drugs: results of a predefined sub-analysis of CareRA, a pragmatic RCT.

Authors:  Veerle Stouten; Stijn Michiels; René Westhovens; Diederik De Cock; Amy Belba; Sofia Pazmino; Kristien Van der Elst; Johan Joly; Patrick Verschueren
Journal:  Clin Rheumatol       Date:  2020-03-12       Impact factor: 2.980

Review 9.  Efficacy, tolerability and cost effectiveness of disease-modifying antirheumatic drugs and biologic agents in rheumatoid arthritis.

Authors:  Michael T Nurmohamed; Ben A C Dijkmans
Journal:  Drugs       Date:  2005       Impact factor: 9.546

10.  Pulmonary abscess due to leflunomide use in rheumatoid arthritis: a case report.

Authors:  H Ulusoy; A Bilgici; O Kuru; C Celenk
Journal:  Rheumatol Int       Date:  2004-08-21       Impact factor: 2.631

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