Leflunomide in rheumatoid arthritis: recommendations through a process of consensus

Abstract

On the basis of efficacy, safety and cost, leflunomide should be considered in patients with RA who have failed first-line DMARD drug therapy. In refractory cases, leflunomide may be used in combination with, for example, methotrexate before biological agents. Therapy should be initiated by a specialist, but repeat prescribing in general practice on a shared care basis is acceptable using agreed protocols. Clear mechanisms are required to monitor toxicity, with good communication between the patient and rheumatologist to manage nuisance side-effects and avoid unnecessary discontinuation of leflunomide.

Long Term Use of Leflunomide as a Cause of Severe Diarrhea?

“…Strand V et al (6) reported diarrhea in frequency of 33.5% in patients with RA treated with leflunomide. Withdrawal rate because of diarrhea was %1.9 in leflunomide trials (10).…”

Leflunomide an Immunosuppressive Drug for Antiviral Purpose in Treatment for BK Virus-Associated Nephropathy After Kidney Transplantation

“…Leflunomide (Arava ® ) is a disease-modifying antirheumatic drug (DMARD) used in adult patients with methotrexate intolerance, failure or loss of efficiency; it is also used in a second www.intechopen.com line to treat severe and active forms of psoriatic arthritis (Maddison et al 2005; SanofiAventis 2009).…”

Pharmacogenetics of rheumatoid arthritis: Potential targets from susceptibility genes and present therapies

“…133 This DMARD is usually an alternative for MTX-intolerant or resistant RA patients. 134 The main molecular target of leflunomide is dihydroorotate dehydrogenase (DHODH), a key enzyme of de novo pyrimidine synthesis. The human DHODH gene sequence is highly conserved and contains only one common missense polymorphism (rs3213422) located in the first exon of the DHODH gene (19CA; Q7K).…”