Leflunomide for rheumatoid arthritis

• leflunomide is a disease-modifying drug (DMARD) that is licensed for the treatment of active rheumatoid arthritis (RA) in adults
  
  
• evidence suggests that leflunomide is an effective DMARD for adults with active RA; the benefits of treatment are evident as improvement in tender and swollen joints - these benefits are evident by 4 weeks after starting treatment
  
  
• in comparison with methotrexate or sulphasalazine, leflunomide appears to be similarly effective - however leflunomide appears to more likely to cause unwanted effects
  
  
• unwanted effects with leflunomide appear to be more likely if given concomitantly with, or started just after switching from, another DMARD with a similar toxity profile; unwanted effects appear to be more likely if there is a switch to another DMARD without elimination of leflunomide's active metabolite
  
  
• because of the long half-life of leflunomide it takes a long time to achieve a steady-state concentration

The summary of product characteristics should be consulted before prescribing this drug.

Reference:

• (1) Drug and Therapeutics Bulletin 2000; 38 (7):52-4.