Peripheral neuropathy: an unwanted effect of leflunomide?

Carulli, Maresa; Davies, U M

doi:10.1093/rheumatology/41.8.952

Cited by 48 publications

(17 citation statements)

References 3 publications

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“…[12][13][14][15][16][17] Although the drug was thought to be relatively safe, there have been many reports of adverse effects in the gastrointestinal, 18 hepatic, [19][20][21][22][23] hematological, 24-27 dermatological, 28 and neurological systems. 29,30 This drug had been expected to be associated with a lower incidence of lung injury than MTX; however, many cases of acute lung injury have been reported since the drug was released in September 2003. 5 Approximately 5000 patients were treated with leflunomide and the occurrence of lung injury was estimated as approximately 1.1%, which seems to be far higher than the figure recorded in Western countries.…”

Section: Discussionmentioning

confidence: 99%

Leflunomide-related lung injury in patients with rheumatoid arthritis: imaging features

et al. 2005

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Imaging findings of 26 cases of leflunomide (Arava)-related acute lung injury were analyzed. Thirteen cases had pre-existing interstitial pulmonary disease on chest X-ray or computed tomography. The main features of clinically determined leflunomide-induced acute lung injury were similar to those caused by other drugs: diffuse or widespread patchy ground-glass opacities and/or consolidation, frequently accompanied by septal thickening and intralobular reticular opacities. We categorized these findings into four patterns: diffuse alveolar damage (DAD), acute eosinophilic pneumonia, hyperreaction, and cryptogenic organizing pneumonia. The DAD group had a higher mortality rate, but statistically not a significant one. It is impossible to exclude infectious disease such as pneumocystis carinii pneumonia based on imaging findings, and detailed correlation of imaging findings with clinical and laboratory findings is essential in order to make a correct diagnosis.

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Section: Discussionmentioning

confidence: 99%

Leflunomide-related lung injury in patients with rheumatoid arthritis: imaging features

et al. 2005

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“…in prerelease clinical trials, but it was subsequently recognized that an axonal, sometimes painful, sensorimotor polyneuropathy is associated with leflunomide [30][31][32]. The mechanism of neurotoxicity is unknown.…”

Section: Discussionmentioning

confidence: 99%

Effect of leflunomide on sciatic nerve of adult albino rats

Abd-El-Hafez¹

2014

The Egyptian Journal of Histology

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“…[400][401][402] Analysis of 80 neuropathy cases reported to the FDA demonstrated a mean time to symptom onset of 6 months (range, 3 days-3 years); a better outcome was associated with stopping the drug within 30 days of symptom onset. 401 The neuropathy associated with lefl unomide may be due to perineural vasculitis.…”

Section: Lefl Unomidementioning

confidence: 99%

Monitoring of Nonsteroidal Immunosuppressive Drugs in Patients With Lung Disease and Lung Transplant Recipients

Baughman

Meyer

Nathanson

et al. 2012

Chest

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Objectives: Immunosuppressive pharmacologic agents prescribed to patients with diffuse interstitial and infl ammatory lung disease and lung transplant recipients are associated with potential risks for adverse reactions. Strategies for minimizing such risks include administering these drugs according to established, safe protocols; monitoring to detect manifestations of toxicity; and patient education. Hence, an evidence-based guideline for physicians can improve safety and optimize the likelihood of a successful outcome. To maximize the likelihood that these agents will be used safely, the American College of Chest Physicians established a committee to examine the clinical evidence for the administration and monitoring of immunosuppressive drugs (with the exception of corticosteroids) to identify associated toxicities associated with each drug and appropriate protocols for monitoring these agents. Methods: Committee members developed and refi ned a series of questions about toxicities of immunosuppressives and current approaches to administration and monitoring. A systematic review was carried out by the American College of Chest Physicians. Committee members were supplied with this information and created this evidence-based guideline. Conclusions: It is hoped that these guidelines will improve patient safety when immunosuppressive drugs are given to lung transplant recipients and to patients with diffuse interstitial lung disease. CHEST 2012; 142(5):e1S-e111SAbbreviations: ACCP 5 American College of Chest Physicians; ALT 5 alanine aminotransferase; ATG 5 antithymocyte globulin; CHF 5 congestive heart failure; CMV 5 cytomegalovirus; CNI 5 calcineurin inhibitor; COI 5 confl ict of interest; CsA 5 cyclosporin A; FDA 5 US Food and Drug Administration; HBV 5 hepatitis B virus; HMG-CoA 5 b -hydroxy-bmethylglutaryl-coenzyme A; HSP 5 Health and Science Policy Committee; IL2RA 5 IL-2 receptor a ; ILD 5 interstitial lung disease; IPF 5 idiopathic pulmonary fi brosis; ITP 5 idiopathic thrombocytopenia purpura; LAM 5 lymphangioleiomyomatosis; MESNA 5 sodium 2-sulfonylethanesufonate; MPA 5 mycophenolic acid; mTOR 5 mammalian target of rapamycin; PTLD 5 posttransplant lymphoproliferative disease; RCT 5 randomized controlled trial; SIRS 5 systemic infl ammatory response syndrome; TNF 5 tumor necrosis factor; TPMT 5 thiopurine methyltransferase

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Peripheral neuropathy: an unwanted effect of leflunomide?

Cited by 48 publications

References 3 publications

Leflunomide-related lung injury in patients with rheumatoid arthritis: imaging features

Leflunomide-related lung injury in patients with rheumatoid arthritis: imaging features

Effect of leflunomide on sciatic nerve of adult albino rats

Monitoring of Nonsteroidal Immunosuppressive Drugs in Patients With Lung Disease and Lung Transplant Recipients

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