Leflunomide-induced chronic cough in a rheumatoid arthritis patient with pulmonary tuberculosis

Verma, Sanjeev; Mishra, Ashwini Kumar; Jaiswal, Ashish

doi:10.1136/bcr-2012-008373

Cited by 3 publications

(2 citation statements)

References 8 publications

(4 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Infection caused death in two patients, discontinuation in three patients, and one patient was diagnosed with pulmonary TB. In keeping with this, infection-related deaths occurred in two patients in each of two previous studies at our centre, and LEF-associated TB has been reported elsewhere [Hodkinson et al 2012[Hodkinson et al , 2015Verma et al 2013]. The majority of our patients were prescribed low-dose oral corticosteroids, and this may have contributed to the high infection rate, although corticosteroids as a risk for infection did not reach statistical significance.…”

Section: Discussionsupporting

confidence: 80%

Combination leflunomide and methotrexate in refractory rheumatoid arthritis: a biologic sparing approach

Hodkinson

Magomero

Tikly

2016

Therapeutic Advances in Musculoskeletal

View full text Add to dashboard Cite

Background: In resource-constrained settings where biologic agents are not widely available, there are limited therapeutic options for patients with rheumatoid arthritis (RA) refractory to other synthetic disease modifying antirheumatic (DMARD) therapies. The aim of this study is to evaluate the effectiveness and safety of leflunomide (LEF) with methotrexate (MTX) in refractory RA. Methods: A retrospective record review of adult RA patients treated with LEF/MTX. Demographic details, adverse reactions, and the 3-variable 28 joint disease activity score (DAS28-3) were recorded at initiation of LEF/MTX therapy, and after 4 and 12 months of treatment. Results: Of 194 patients, most were middle-aged seropositive Black African females, with established disease [mean (standard deviation, SD) disease duration 9.4 (8.2) years] and time on previous DMARDs of 7.0 (5.5) years. Before adding LEF, the mean (SD) dose of MTX was 21.7 (3.5) mg/week, and 87.6% of patients used low dose oral corticosteroids. A good or moderate EULAR response was achieved by 44% and 42% of patients, and the retention rate was 71%. Major infections were seen in 6 patients: comprising 2 deaths, 3 cases of leucopaenia and septicaemia and 1 case of tuberculosis. Hepatotoxicity (n = 3), intolerable gastrointestinal symptoms (n = 3), and hypertension (n = 17) were the most common problems. Predictors of remission or low disease activity at 12 months was a baseline DAS28-3 ⩽ 5.5 [odds ratio (OR) = 2.7; 95% confidence interval (CI) 1.1–5.6; p = 0.01]. Conclusions: LEF/MTX was effective in the majority of patients in this cohort of mainly Black African women who failed other combination synthetic DMARDs, particularly in those with moderate disease activity at the time of addition of LEF. Infections and hypertension were important complications. In a setting where biologic DMARDs are not readily accessible, the combination of LEF/MTX is a cost-effective approach.

show abstract

Section: Discussionsupporting

confidence: 80%

Combination leflunomide and methotrexate in refractory rheumatoid arthritis: a biologic sparing approach

Hodkinson

Magomero

Tikly

2016

Therapeutic Advances in Musculoskeletal

View full text Add to dashboard Cite

show abstract

“…Cough can also be caused by mycophenolate mofetil, macrodantin, propofol, β-receptor blockers, leflunomide, simvastatin, γ-interferon, and omeprazole (29,(365)(366)(367).…”

Section: Cough Due To Acei or Other Medicationsmentioning

confidence: 99%

Clinical Practice Guidelines for Diagnosis and Management of Cough—Chinese Thoracic Society (CTS) Asthma Consortium

Lai

Shen

Zhou³

et al. 2018

J. Thorac. Dis

View full text Add to dashboard Cite

of cough was added; (V) the etiology and management of chronic cough in children was introduced; (VI) a section on uncommon causes of chronic cough; and (VII) added unexplained cough [refractory cough, cough hypersensitivity syndrome (CHS)]. Introduction of methodology (I) The target population: patients with cough. (II) The target users: respiratory specialists from all levels of hospitals, physicians of internal medicine and TCM, general practitioners, pediatricians, and other health-care providers.

show abstract

Leflunomide

2013

Reactions Weekly

View full text Add to dashboard Cite

Leflunomide-induced chronic cough in a rheumatoid arthritis patient with pulmonary tuberculosis

Cited by 3 publications

References 8 publications

Combination leflunomide and methotrexate in refractory rheumatoid arthritis: a biologic sparing approach

Combination leflunomide and methotrexate in refractory rheumatoid arthritis: a biologic sparing approach

Clinical Practice Guidelines for Diagnosis and Management of Cough—Chinese Thoracic Society (CTS) Asthma Consortium

Leflunomide

Contact Info

Product

Resources

About