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Leflunomide in Pakistani patients with rheumatoid arthritis: prospective study in daily rheumatology practice
Author(s) -
AHMAD Nighat M.,
FARMAN Sumaira,
SAEED Muhammad A.,
HAMEED Rafaqat,
UMAIR Muhammad,
GHAFOOR Erum
Publication year - 2011
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/j.1756-185x.2010.01586.x
Subject(s) - leflunomide , medicine , rheumatoid arthritis , rheumatology , adverse effect , prospective cohort study , methotrexate
Leflunomide is a disease‐modifying anti‐rheumatic drug (DMARD) for rheumatoid arthritis (RA). It has been widely studied in the West but there is no available local Pakistani data. Objective: To evaluate the efficacy and safety profile of leflunomide in Pakistani patients with RA, either alone or in combination with methotrexate. Materials and methods: A prospective, non‐comparator, open‐label study in a setting of ‘care as usual’ was performed. In this study, 63 consecutive RA patients on leflunomide were enrolled. Leflunomide dose was started with full loading in 5 (8%), half loading in 39 (62%) and without loading in 19 (30%) patients. Methotrexate was also used in 20 (32%) patients. Primary end‐point was 20% improvement in American College of Rheumatology response criteria (ACR‐20). Safety was assessed by adverse events and abnormalities in laboratory parameters. Results: Out of 63 patients, 54 (85.7%) were female. Mean age was 46 ± 12.6 years. Mean disease duration was 5.1 ± 4.5 years. Fifty‐two (86.6%) patients achieved ACR‐20 response at 6 months; 32 (53%) achieved ACR‐50 response at 6 months; 20% experienced at least one adverse event, which resolved by reducing leflunomide dose. Only seven (11%) had raised liver enzymes from baseline. Conclusion: This prospective study conducted in the setting of a daily rheumatology practice shows that leflunomide is an effective and safe DMARD in treatment of RA in Pakistani patients.