Arava & Mtx

Addition Of Leflunomide (Arava) To Methotrexate May Be Beneficial In Rheumatoid Arthritis

WESTPORT, Jul 21 (Reuters Health) - Adjunctive leflunomide may benefit patients with rheumatoid arthritis whose disease remains active despite long-term methotrexate therapy, according to the results of an open-label study. Dr. Michael E. Weinblatt, of Brigham and Women's Hospital in Boston, Massachusetts, and a multicenter group treated 30 such patients with leflunomide, 10 to 20 mg/day, in addition to continuing methotrexate at a mean dosage of 17 mg/week. Of the 23 patients who completed 1 year of combination treatment, 16 patients met American College of Rheumatology (ACR) criteria for response and two patients met ACR criteria for remission, Dr. Weinblatt's group observed. The investigators report in the July issue of Arthritis & Rheumatism that, overall, combination therapy "...appeared to be reasonably well tolerated," except for "...mild-to-moderate gastrointestinal and respiratory symptoms and abnormalities on liver function tests." Three patients stopped treatment with leflunomide because of persistently elevated plasma transaminase levels. "Because the overall risk of serious liver damage when methotrexate and leflunomide are used together is unknown, careful dose titration and patient monitoring will be necessary," the investigators caution. They report that a randomized trial of the combination regimen is under way.

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