Title: Use of Non Biologic DMARD in Rheumatoid Arthritis with Emphasis on Leflunomide
Authors: Jacob Antony, Ajith S.N
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.169
Abstract
Background: Being the commonest rheumatoligical disease the treatment of rheumatoid arthritis requires optimisation. The use of disease modifying medications in rheumatoid arthritis needs particular emphasis. Many patients presents late with deformities resulting in significant morbidity.
Methods: We conducted a prospective study involving 60 patients with active rheumatoid arthritis and a double blind comparison sub study in which outcome of treatment of 35 patients were analysed between methotrexate and leflunomide.
Results: The 60 patients studied were predominantly women (mean age, 52 years; mean disease duration, 4.5 years) The ACR response for patients receiving leflunomide treatment was 52% and that of methotrexate treatment was 48%. They were statistically equivalent, with mean time to initial response at 8.2 weeks for patients receiving leflunomide vs 9.1 weeks for patients receiving methotrexate therapy. X-ray analyses demonstrated less disease progression with both arms of the study. Common adverse events for patients receiving leflunomide treatment included gastrointestinal complaints, skin rash, and reversible alopecia.
Conclusions: Current treatments for rheumatoid arthritis (RA) include nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose steroids, and disease-modifying antirheumatic drugs (DMARDs). No currently available medication is uniformly effective, and all may cause significant adverse effects. The active control drug for this study, methotrexate, is considered to be the "gold standard" DMARD for the treatment of RA.
Clinical responses following administration of leflunomide, a relatively new therapeutic agent for the treatment of RA, were statistically equivalent to those with methotrexate treatment. Both treatments improved signs and symptoms of active RA, delayed disease progression as demonstrated by x-ray films, and improved function and health-related quality of life.
Keywords: Rheumatoid arthritis, DMRD, Leflunomide, Methotrexate.
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