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(Leflunomide), (DMARD ) Disease Modifying Anti-Rheumatic Drugs
Objective: To assess leflunomide's short-term effectiveness in patients with active rheumatoid arthritis.
Study design: A Descriptive Cross Sectional Study
Duration and place of study: Department of Medical B Unit Lady Reading’s hospital Peshawar. from 1st June 2022 to 31st May 2023
Methodology: The Medical B Unit of MTI Lady Readings Hospital in Peshawar hosted this descriptive cross-sectional research, Over a period of one year from June 1, 2022, to May 31, 2023. This research comprised 147 individuals with active RA (DAS28>5.1). Patients enrolled in the trial were administered 20 mg of leflunomide daily. Using the European League against Rheumatisms (EULAR) standards, the effectiveness of both medications was evaluated after six months of therapy in terms of DAS 28 scores.
Results: Following a 6-month course of therapy with leflunomide, 47 patients saw no response, while 100 patients (68.02%) showed a moderate response. Leflunomide caused a mean change in DAS 28 score of 1.79 ±0.75.
Conclusion: Based on EULAR response criteria, leflunomide showed a considerable short-term effectiveness in RA patients.
2. Moreland LW, Russell AS, Paulus HE. Management of rheumatoid arthritis: the historical context. J rheumatol 2001; 28:1431-522.
3. Taqweem A, Ahmed I, Alam I, Ali Z, Nowsherawan, Mehboob A. Short-term effectiveness of methotrexate in the treatment of active rheumatoid arthritis. J Postgrad Med Inst 2010; 24:252.
4. Li EK1, Tam LS, Tomlinson B. Leflunomide in the treatment of rheumatoid arthritis. Clin Ther 2004; 26:447-59.
5. Curtis JR, Beukelman T, Onofrei A, Cassell S, Greenberg JD, Kavanaugh A, et al. Elevated liver enzyme tests among patients with rheumatoid arthritis or psoriatic arthritis treated with methotrexate and/or leflunomide. Ann Rheum Dis 2010; 69:43-7.
6. Baig S, Humail M, Zaidi IS, Noor S, Anwar S, Rehman S. Toxicity profiles of disease modifying anti-rheumatoid drugs(DMARDS) in rheumatoid arthritis patients in Karachi. Pak Orthop Assoc 2009; 21:38-43.
7. Behrens F, Koehm M, Burkhardt H. Update 2011: leflunomide in rheumatoid arthritis - strengths and weaknesses. Curr Opin Rheumatol 2011; 23:282-7.
8. Smolen JS, Landewé R, Breedveld FC, Dougados M, Emery P, Gaujoux-Viala C, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biologic disease modifying antirheumatic drugs. Ann Rheum Dis 2010; 69:964–75.
9. Cutolo M, Bolosiu H, Perdriset G, LEADER Study Group. Efficacy and safety of leflunomide in DMARD-naive patients with early rheumatoid arthritis: comparison of a loading and a fixed-dose regimen. Rheumatology (Oxford) 2013; 52:1132-40.
10. Taqweem A, Ahmad I, Nowsherawan, Ali Z, Mehboob A. Short-term effectiveness of leflunomide in treatment of active rheumatoid arthritis. J Postgrad Med Inst 2010; 24:153-9
11. Ishaq M, Muhammad J, Hameed K, Mirza I A. Leflunomide or Methotrexate? Comparison of clinical efficacy and safety in low socio-economic rheumatoid arthritis patients. Mod Rheumatol2011; 21:375-80.
12. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Ann Rheum Dis 2010; 69:1580–8.
13. Fransen J, van Riel. PL. The Disease Activity Score and the EULAR response criteria. Rheum Dis Clin North Am. 2009 2009; 35:745-57.
14. Strand V, Cohen S, Schiff M, Weaver A, Fleischmann R, Cannon G, et al. Treatment of active Rheumatoid Arthritis with Lelunamide compared to Placebo and Methotrexate, Lelunomide Rheumatoid Arthritis Investigator group. Arch Intern Med 1999; 159: 2542-50.
15. Singer O, Gibofsky A. Methotrexate versus leflunomide in rheumatoid arthritis: what is new in 2011? Curr Opin Rheumatol 2011; 23:288-92.
16. Favalli EG, Bugatti S, Biggioggero M, Caporali R. Treatment comparison in RA: Head to Head trials and innovative study designs. Bio Med Res Int 2014; 2014:831603.
17. Osiri M, Shea B, Robinson V, Suarez-Almazor M, Strand V, Tugwell P, et al. Leflonamide for the treatment of RA. Cochrane Database Syst Rev 2003:CD002047.
18. Gaujoux-Viala C, Dougados M, Smolen JS. Leflunomide appears efficacious and as efficacious as methotrexate on signs and symptoms, function and structure in RA: a mata-analysis of randomized controlled trials. Ann Rheum Dis 2009; 69:214.
19. Fedorenko E, Lukina GV, Sigidin YA. Effects of 4 different treatment regimens on radiographic progression in early RA. Ann Rheum Dis 2010; 69: 214.f prospective non interventional study. Clin Rheum Dis 2010; 29:913-20.