[Leflunomide-related severe axonal neuropathy].
BACKGROUND
Leflunomide is a new drug for the treatment of rheumatoid arthritis. Its mechanism of action is based on lymphocyte inhibition. We report the cases of two patients treated with leflunomide who developed severe sensory-motor axonal polyneuropathy.


METHODS
Two women (61- and 70-year-old) presented with a sensory-motor axonal polyneuropathy beginning 5 months after onset of leflunomide treatment. Etiologic investigations were negative. The symptoms rapidly improved after withdrawing leflunomide.


CONCLUSIONS
The analysis of drug watch data found twelve patients with leflunomide-related neuropathy. Ten of them were more than 60 years old. The mean delay for onset of neuropathy was 9 months. The neuropathy improved after treatment withdrawal in seven patients.


CONCLUSIONS
We consider these data strongly suggest that leflunomide is a cause of axonal sensory-motor neuropathy. The prevalence of such adverse events is still unknown.
Gabelle
A
A
Service d'Explorations Neurologiques et d'Epileptologie, Hôpital Gui-de-Chauliac, Montpellier. audreygabelle@hotmail.com
Antoine
J C
JC
Hillaire-Buys
D
D
Coudeyre
E
E
Camu
W
W
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001369:Axons / Q000187:drug effects* / Q000473:pathology*; D003389:Cranial Nerve Diseases / Q000139:chemically induced* / Q000473:pathology*; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000009:adverse effects*; D000077339:Leflunomide; D008875:Middle Aged; D012720:Severity of Illness Index
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007555:Isoxazoles; D000077339:Leflunomide