Efficacy and safety of leflunomide in psoriatic arthritis treatment: A single‐arm meta‐analysis

Abstract

Aim:To systematically assess the clinical efficacy and safety of leflunomide for treating psoriatic arthritis (PsA).Methods: PubMed, Embase, and Cochrane Library databases were searched until 1 January, 2018, to include relevant studies in this single-arm meta-analysis. Psoriasis improvement was evaluated using Psoriasis Area and Severity Index (PASI) scores.The primary outcome in patients was assessed using the Psoriatic Arthritis Response Criteria (PsARC). Other effectiveness evaluations included those of adverse events, quality of life including functional status (Health Assessment Questionnaire [HAQ] total score), and a quality-of-life instrument for dermatologic diseases (Dermatology Life Quality Index [DLQI] total score). Results:A total of 6 studies were included. After leflunomide treatment, 48% of the patients experienced a reduction of ≥50% based on PASI scores (95% confidence interval [CI]: 0.22-0.73). PASI 75 improvement was observed among 25% of the patients (95% CI: 0.11-0.38). The primary effectiveness analysis revealed that 15% of the patients (95% CI: 0.07-0.26) discontinued leflunomide treatment. Further, 77% of the patients (95% CI: 0.59-0.92) achieved a PsARC response. Adverse events occurred in 38% of the patients (95% CI: 0.04-0.71). The mean ± SD percentage PASI improvement was −4.88 (95% CI: −8.92, −0.85). Moreover, DLQI and HAQ were −2.02 (95% CI: −3.01, −1.03) and −0.19 (95% CI: −0.29, −0.09), respectively. Conclusions:Leflunomide is an effective and well-tolerated treatment for PsA, and would be a safe and convenient option. K E Y W O R D Sleflunomide, meta-analysis, psoriatic arthritis

Efficacy of leflunomide in the treatment of palindromic rheumatism

“…24 Diarrhea is the most common which occurs in 10% of patients. 24 Others include oral ulcers, weight loss, rise in blood pressure, headache, transient increase in transaminases, transient leukopenia, hair loss, peripheral neuropathy and increasing risk of infection. 24 Dropouts because of side effects in our report were comparable with studies which used leflunomide for the treatment of RA.…”

“…24 Others include oral ulcers, weight loss, rise in blood pressure, headache, transient increase in transaminases, transient leukopenia, hair loss, peripheral neuropathy and increasing risk of infection. 24 Dropouts because of side effects in our report were comparable with studies which used leflunomide for the treatment of RA. 17 To the best of our knowledge, this report is the first report about the effect of leflunomide in treating PR.…”

Non-adherence and discontinuation rate for oral and parenteral methotrexate: A retrospective-cohort study in 8,952 patients with psoriatic arthritis

“…We herein confirm that MTX is the most commonly prescribed csDMARD, in particular in the parental formulation. We suggest that the low rate of LEF prescriptions may be secondary to its relatively recent availability during the considered decade [ 17 , 18 ], while we note that the use of HCQ in PsA is not evidence-based nor endorsed by current recommendations.…”

Monitoring of Peripheral Blood Leukocytes and Plasma Samples: A Pilot Study to Examine Treatment Response to Leflunomide in Rheumatoid Arthritis

“…Despite its efficacy, it is estimated that 5-10% of RA patients do not improve with LFN following a six-month treatment [4]. Increases in dosage schemes may result in superior but not always ideal efficacy, and also in greater adverse effects [5][6][7]. In the case of LFN discontinuation, this therapy is replaced by another antirheumatic drug and the patient is then, submitted to another trial course, with no guarantees of successful therapy.…”