NEWS: Leflunomide Can Be Effective for Methotrexate-Resistant Juvenile Arthritis

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Leflunomide Can Be Effective for Methotrexate-Resistant Juvenile

Arthritis

Reuters Health Information 2005. © 2005 Reuters Ltd.

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NEW YORK (Reuters Health) Mar 04 - Leflunomide therapy is well

tolerated and benefits some patients with refractory

polyarticular-course juvenile rheumatoid arthritis (JRA), according to

results of a new study. " The beneficial effect of leflunomide was

maintained over the long term in the majority of patients, " the

researchers report.

Leflunomide has been proven effective in treating adults with

rheumatoid arthritis, the authors explain in the February issue of

Arthritis & Rheumatism, but there have been no previous reports on the

efficacy of leflunomide in pediatric patients.

Dr. Earl Silverman from Hospital for Sick Children in Toronto, Ontario,

Canada, and colleagues investigated the effectiveness and long-term

safety of leflunomide in 27 patients with polyarticular-course JRA who

had not responded completely to or could not tolerate treatment with

methotrexate.

The maximum response rate of 52% occurred by week 12 and persisted

through week 26, the team reports. A similar percentage of patients who

participated in the extension study continued to meet the response

criteria after 106 weeks of treatment.

At the last study visit (week 130), 65% of patients maintained at least

a 30% improvement in the physician's global assessment and 59% had

improvement in the patient's/parent's global assessment, the results

indicate.

The patients reported 13 serious adverse events, the researchers note,

but only 7 of them (3 patients) were deemed possibly or probably

related to leflunomide.

" The adverse effect profile was similar to that seen in studies of

leflunomide in adults with RA, " the investigators write, " which

included elevations of results of liver function tests, abdominal pain,

nausea, alopecia, mouth ulcers, and skin rash. "

They conclude, " The findings of this study therefore support further

evaluation of leflunomide for the treatment of polyarticular-course

JRA. "

Arthritis Rheum 2005;52:554-562.

http://www.medscape.com/viewarticle/500792

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