Leflunomide-induced interstitial lung disease: prevalence and risk factors in Japanese patients with rheumatoid arthritis

Abstract

Pre-existing ILD was the most important risk factor for LEF-induced ILD. We suggest that LEF should not be prescribed for RA patients complicated with ILD.

Established and experimental medical therapy of pulmonary sarcoidosis

“…In a post-marketing survey in Japan, 1.2% of patients treated with leflunomide were reported to have developed interstitial lung disease [116]. In rheumatoid arthritis, the presence of pretreatment for interstitial lung disease was a risk factor for developing fatal pulmonary toxicity [117].…”

“…In rheumatoid arthritis, the presence of pretreatment for interstitial lung disease was a risk factor for developing fatal pulmonary toxicity [117]. Prior or concurrent therapy with methotrexate was also a risk factor for developing pneumonitis [114,116]. Sarcoidosis patients who develop an intractable cough while receiving methotrexate have been successfully treated with leflunomide with no further pulmonary symptoms [91].…”

Cavitary pulmonary nodules in rheumatoid arthritis; case reports and review of the literature

“…This agent targets the activated T cells and suppresses inflammatory reaction on synovium in RA (16). Although LEF therapy was reportedly less than other anti-rheumatic drugs such as MTX, TNF-alpha inhibitors in patients with RA with pulmonary non-cavitary nodules and fatal interstitial lung disease in this review, the high frequency of LEF therapy in patients with RA with cavitary pulmonary nodules should be emphasized (17)(18)(19). However, the underlying mechanism for the association between LEF therapy and the pulmonary cavitary lesion is not known at present.…”

Pulmonary Nodulosis Associated with Leflunomide Therapy in Rheumatoid Arthritis: Report of Four Cases and Review of the Literature

“…However, depending on localization, they may cause hemoptysis, bronchopleural fistula or pneumothorax. Pulmonary abscess, pneumonia and fatal interstitial lung diseases have been reported rarely during leflunomide treatment [17][18][19]. Leflunomide is an effective disease-modifying drug in the treatment of rheumatoid arthritis.…”