Leflunomide in rheumatoid arthritis in daily practice: treatment discontinuation rates in comparison with other DMARDs.
OBJECTIVE
To evaluate the treatment discontinuation rate of leflunomide in rheumatoid arthritis (RA) in comparison with the discontinuation of other disease modifying anti-rheumatic drugs (DMARDs), in daily practice, in a single center and during the same period of time.


METHODS



METHODS
3-year, retrospective, monocenter.


METHODS
RA patients for whom leflunomide or another DMARD was initiated between 1998 and 2001 (several DMARDs could be initiated for a given patient during this period). Collected data: For each patient, demographic and disease data. For each treatment course, date of initiation, if relevant date of discontinuation and reason for discontinuation.


METHODS
Percentage of patients discontinuing treatment over time (life table method; Kaplan-Meier), comparison between leflunomide and the "any other DMARD" or methotrexate groups using the Log-Rank test.


RESULTS
During the study period, 515 DMARDs were initiated in 285 patients. Leflunomide was initiated in 161 patients who were older and had a longer disease duration than the other treated patients (59 +/- 13 years and 14 +/- 9 years versus 54 +/- 15 years and 11 +/- 10 years in the leflunomide group and other DMARDs group respectively). Discontinuation rate of leflunomide after 1 year was 56.7%, mainly because of adverse drug reactions (41.6%). The discontinuation rate whatever the reason and for toxicity was higher for leflunomide than for other DMARDs studied. However discontinuation for inefficacy was similar in both groups.


CONCLUSIONS
This study conducted in conditions of daily practice when leflunomide was first available suggests a higher discontinuation rate of leflunomide because of adverse events when compared to other DMARDs.
Bettembourg-Brault
I
I
Rheumatology B Department, Cochin Hospital, AP-HP, Rene Descartes University, Paris, France.
Gossec
L
L
Pham
T
T
Gottenberg
J-E
JE
Damiano
J
J
Dougados
M
M
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use*; D000077339:Leflunomide; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D017211:Treatment Failure; D016312:Treatment Refusal / Q000706:statistics & numerical data*
D000276:Adjuvants, Immunologic; D018501:Antirheumatic Agents; D007555:Isoxazoles; D000077339:Leflunomide