title: Clinical outcomes of low-dose leflunomide for rheumatoid arthritis complicated with Hepatitis B virus carriage and safety observation.
abstract: OBJECTIVE
  To study the clinical outcomes of low-dose leflunomide for rheumatoid arthritis (RA) complicated with hepatitis B virus (HBV) carriage and to observe the safety.
  
  
  METHODS
  A total of 115 RA patients were divided into three groups according to the state of HBV. They were all given leflunomide to observe the clinical outcomes and whether HBV was activated.
  
  
  RESULTS
  The indices (e.g. activity score) of all patients were significantly better after treatment than those before (P < 0.05), with 89.00% (92/115) of them reaching ACR20. Fourteen cases (12.2%) suffered from abnormal liver functions, and 5 cases who had HBV reactivation originated from the HBV carriage group. Neither the previous HBV infection group nor the infection-free group succumbed to HBV reactivation. The multiple regression model showed that the HBV reactivation risk of RA patients treated by leflunomide was increased by 30% by the basic state of hepatitis B as well as alanine transaminase level and swollen joint count before treatment.
  
  
  CONCLUSIONS
  Leflunomide exerted satisfactory therapeutic effects on RA, but liver diseases, liver function, HBV-DNA load and the reactivation risks of carried HBV should be thoroughly checked and cautiously pondered.
authors.affiliation: Ming-Hua Xu, Department of Rheumatology, Affiliated Hospital of Hebei University, Baoding 071000, P.R. China.
authors.forename: Hua
authors.initials: H
authors.lastname: Ming-Xu
authors.affiliation: Meng Chen, Department of Rheumatology, Graduate School of Hebei Medical University, Shijiazhuang 050017, P.R. China. Affiliated Hospital of Hebei University, Baoding 071000, P.R. China.
authors.forename: Meng
authors.initials: M
authors.lastname: Chen
authors.affiliation: Yun Cai, Department of Internal Medicine-Neurology, Affiliated Hospital of Hebei University, Baoding 071000, P.R. China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Cai
authors.affiliation: Yan-Hui Jia, Department of Rheumatology, Affiliated Hospital of Hebei University, Baoding 071000, P.R. China.
authors.forename: Hui
authors.initials: H
authors.lastname: Yan-Jia
keywords: Clinical outcome; Hepatitis B; Leflunomide; Rheumatoid arthritis; Safety