Changes in inflammatory activity of rheumatoid arthritis at early stages of basic therapy with leflunomide

Abstract


Aim. To assess leflunomide efficacy and tolerance in patients with rheumatoid arthritis (RA) during the first four months of the treatment.
Material and methods. The study included 200 RA patients treated in four Moscow clinical centers. Leflunomide was given in a dose of 100 mg/day for 3 days, then 20 mg/day for 16 weeks. The activity of the disease according to the criterion DAS 28 was assessed before the treatmend and 4, 8, 12 and 16 weeks after the treatment start.
Results. RA activity diminished considerably after one month of leflunomide treatment. Later, the articular syndrome continued to improve. A significant improvement by DAS 28 was observed after 16 weeks of the treatment in 65% (129 of 200) patients, high RA activity persisted only in 17 of 90 patients.
Conclusion. Leflunomide reduces articular inflammation and raises RA patients' quality of life at early stages of the treatment. This reduction continued for 4 months of the study. Therefore, adequate assessment of leflunomide efficacy should be made only after 4-6 months of therapy.

References

  1. Aletaha D., Smolen J. S. The rheumatoid arthritis patient in the clinic: comparing more than 1300 consecutive DMARD courses. Rheumatology 2002; 41: 1367-1374.
  2. Bartlett R. R., Schkyerbach R. Immunopharmacological profile of a novel isoxazol derivative, HWA 486, with potential antirheumatic activity-I. Disease modifying action on adjuvant arthritis of the rat. Int. J. Immunopharmacol. 1985; 7 (1): 7-18.
  3. Cao W. W., Kao P. N., Chao A. C. et al. Mechanism of the antiproliferative action of leflunomide. A77 1726, the active metabolite of leflunomide, does not block T-cel receptor-mediated signal transduction but its antiproliferative effects are antagonized by pyrimidine nucleosides. J. Heart Lung Transplant. 1995; 14 (6, pt 1): 1016-1030.
  4. Siemasko К. F., Chong A. S. F., Williams J. W. et al. Regulation of В cell function by the immunsuppressive agent leflunomide. Transplantation 1996; 61: 635-642.
  5. Williams J. W., Xiao F., Foster P. et al. Leflunomide in experimental transplantation: control of rejection and alloantibody production, reversal of acute rejection, and interaction with cyclosporin. Transplantation 1994; 57: 1223.
  6. Hamilton L. C., Vojnovic I., Warner T. D. A771726, the active metabolite of leflunomide, directly inhibits the activity of cyclo-oxygenase-2 in vitro and in vivo in a substrate-sensitive manner. Br. J. Pharmacol. 1999; 127 (7): 1589-1596.
  7. Kraan M. C., Reece R. J., Barg E. С. et al. Modulation of inflammation and metalloproteinase expression in synovial tissue by leflunomide and methotrexate in patients with active rheumatoid arhtrits. Findings in a prospective, randomized, double-blind, parallel-design clinical trial in thirty-nine patients at two centers. Arthr. and Rheum. 2000; 43 (8): 1820- 1830.
  8. Emery P., Breedveld F. C., Lemmel E. M. et al. A comparison of the efficacy and safety of leflunomide and methotrexate for the treatment of rheumatoid arthritis. Rheumatology 2000; 39 (6): 655-665.
  9. Smolen J. S., Kalden J. R., Scott D. L. et al. Efficacy and safety of leflunomide compared with placebo and sulphasalazine in active rheumatoid arthritis: a double-blind, randomised, multicentre trial. European Lefluonomide Study Group. Lancet 1999; 23: 353 (9149): 259-266.
  10. Strand V., Cohen S., Schiff M. et al. Treatment of active rheumatoid arthritis with leflunomide compared with placebo and methotrexate. Leflunomide Rheumatoid Arthritis Investigators Group. Arch. Intern. Med. 1999; 159 (21): 2542-2550.
  11. Sharp J. Т., Strand V., Leung H. et al. Treatment with leflunomide slows radiographic progression of rheumatoid arthritis: results from three randomized controlled trials of leflunomide in patients with active rheumatoid arthritis. Leflunomide Rheumatoid Arthritis Investigataors Group. Arthr. and Rheum. 2000; 43 (3): 495-505.
  12. Prevoo M. L., van't Hof M. A., Kuper H. H. et al. Modified disease activity scores that include twenty-eight-joint counts. Arthr. and Rheum. 1995; 38 (1): 44-48.
  13. Ruta D. A., Hurst N. P., Kind P. et al. Measuring health status in British patients with rheumatoid arthritis: reliability, validity and responsiveness of the short form 36-item health survey (SF-36). Br. J. Rheumatol. 1998; 37 (4): 425-436.
  14. Smolen J. S., Emery P. Efficacy and safety of leflunomide in active rheumatoid arthritis. Rheumatology 2000; 39 (suppl. 1): 48-56.

Statistics

Views

Abstract - 100

Cited-By


Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.

Copyright (c) 2020 Balabanova R.M., Makolkin V.I., Shostak N.A., Chichasova N.V., Olyunin Y.A., Goryachev D.V., Loginova Т.К., Ryabkova A.A., Petukhova N.V., Menshikova I.V., Igolkina E.V., Chizhova K.A., Nasonov E.L.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Novoslobodskaya str 31c4., Moscow, 127005, Russian Federation

Managing Editor:

 

© 2018 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies