The effect of leflunomide on cold and vibratory sensation in patients with rheumatoid arthritis.
OBJECTIVE
To evaluate the prevalence and risk factors of peripheral neuropathy in patients with rheumatoid arthritis (RA) treated with leflunomide (LEF) by quantitative sensory testing (QST).


METHODS
A total of 94 patients were enrolledin this study, out of which 47 patients received LEF. The other 47 patients received alternative disease-modifying antirheumatic drugs and served as the control group. The demographic characteristics, laboratory findings, concomitant diseases, and medication history were evaluated at the time of QST. The cooling (CDT) and vibratory detection threshold (VDT) as the representative components of QST were measured.


RESULTS
Age, gender, RA duration, ESR, and CRP did not show any significant differences between the two groups. VDT did not demonstrate any significant difference in both groups. However, CDT in LEF group was significantly higher than that of the control group (8.6±2.7 in LEF vs. 5.6±3.8 in control). The proportion of RA patients in the LEF group showing abnormally high CDT was over 2 times greater than that of the control group, but these findings were not statistically significant. Age, RA duration (or LEF medication in LEF group), ESR, and CRP did not show significant correlation with CDT in both groups. VDT significantly correlated with age in both groups.


CONCLUSIONS
LEF treatment in patients with RA may lead to abnormal CDT in QST. CDT value was not affected by age, RA duration, disease activity, or LEF duration. It remains to be determined whether QST may be a valuable non-invasive instrument to evaluate the early sensory changes in patients with RA taking LEF.
Department of Rehabilitation Medicine, Hanyang University College of Medicine, Seoul 133-792, Korea.
Hyung Kuk
HK
Kim
Si-Bog
SB
Park
Jong Woo
JW
Park
Seong-Ho
SH
Jang
Tae-Hwan
TH
Kim
Yoon-Kyoung
YK
Sung
Jae-Bum
JB
Jun