Leflunomide for the treatment of rheumatoid arthritis.
Leflunomide (Arava), Aventis Pharmaceuticals) is an immunomodulating drug that interferes with the metabolism of pyrimidine by inhibiting dihydro-orotate dehydrogenase (DHO-DH) in mitochondria, thereby blocking T- and B cell proliferation. Antibody production is also affected by DHO-DH blockade. Other immunomodulatory effects of leflunomide have also been reported. Symptomatic and structural effects of leflunomide in active rheumatoid arthritis have been strictly evaluated by double-blind, randomised, placebo-controlled studies that were aimed at validating its use in rheumatoid arthritis. Further trials are now required to confirm efficacy and safety of this drug in combination with other agents.
Miceli-Richard
Corinne
C
Cochin Hospital, AP-HP, René Descartes University, Paris, France.
Dougados
Maxime
M
D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D000075202:Contraindications; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000494:pharmacology*; D007555:Isoxazoles / Q000009:adverse effects / Q000494:pharmacology*; D000077339:Leflunomide; D017410:Practice Guidelines as Topic
D007166:Immunosuppressive Agents; D007555:Isoxazoles; D000077339:Leflunomide