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Rheumatoid Arthritis Treatment with Weekly Leflunomide: An Open-Label Study
JORGE JAIMES-HERNÁNDEZ, MANUEL ROBLES-SAN ROMÁN, RODRIGO SUÁREZ-OTERO, M. EUGENIA DÁVALOS-ZUGASTI, and SERGIO ARROYO-BORREGO
ABSTRACT.
Methods. Patients who were clinically active using the American College of Rheumatology criteria for RA were enrolled. They received a loading dose of 100 mg of LFN for 3 days, followed by 100 mg of LFN weekly. Efficacy and adverse events (AE) were recorded. Results. Fifty patients were enrolled; 46 (93.6%) were women with a mean age of 45.6 years (range: 24 to 83). Disease duration was 3.7 years (range: 0.5 to 12). Twenty patients (40.8%) had previously taken disease modifying antirheumatic drugs. Outcomes achieved after 24 weeks of treatment were as follows: ACR20 (74%), ACR50 (64%), and ACR70 (28%). Five patients were withdrawn due to AE: 2 due to urticaria, 2 patients had elevated liver enzymes, and one had thrombocytopenia. Six patients (12%) were lost to followup. No severe AE were seen. Conclusion. The results in our preliminary report indicate that using a 100 mg/week dose achieves a similar benefit to the LFN 20 mg/day treatment, and there were no severe AE. In addition, a single LFN weekly dose has better treatment compliance. A secondary important benefit is the reduction of the monthly cost of medication. Comparative and blind trials are necessary in order to confirm longterm improvement and benefits on this regimen. (J Rheumatol 2004;31:235-7) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the Rheumatology Department, Internal Medicine Division, Centro Médico ISSEMyM, Metepec, State of Mexico. J. Jaimes-Hernández, MD, Head of the Internal Medicine Division, Rheumatologist; M. Robles-San Román, MD, Head of the Rheumatology Department; R. Suárez-Otero, MD, Head of the Internal Medicine Department; M.E. Dávalos-Zugasti, MD, Rheumatologist, Toluca Medical Center; S. Arroyo-Borrego, MD, Rheumatologist, IMSS 220 Hospital. Address reprint requests to Dr. J. Jaimes-Hernández, Centro Médico ISSEMyM, Paseo Tollocan No. 284, San Jerónimo Chicalhualco, Metepec, Estado de México, C.P. 52140. Submitted May 25, 2003; revision accepted July 25, 2003. |