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Rheumatology clinic

Focus on leflunomide

Peter T Nash

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Abstract

There is great interest in leflunomide, a new treatment for rheumatoid arthritis. But what is known about how to use this drug?

Article Extract

What is leflunomide?

Leflunomide is a new drug for treating active rheumatoid arthritis (RA), the first for more than a decade. It belongs to the DMARD (disease modifying antirheumatic drugs) class, along with methotrexate, salazopyrin, hydroxychloroquine, gold and penicillamine.

Leflunomide can reduce erosive damage and disability in RA. It is thought to work by inhibiting pyrimidine synthesis, thereby interfering with the maturation of activated lymphocytes, critical in the inflammatory process. Clinical trials have shown similar efficacy to salazopyrin and conservative doses of methotrexate in reducing pain and joint swelling in active RA, and in preventing the occurrence of new erosions on x-ray.

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