Leflunomide in rheumatoid arthritis in daily practice: treatment discontinuation rates in comparison with other DMARDs

Clinical and Experimental Rheumatology

J. Damiano¹  J.-E. Gottenberg¹  T. Pham¹  I. Bettembourg-Brault¹  L. Gossec¹  M. Dougados¹ 

关键词: Leflunomide;    termination rate;    rheumatoid arthritis;    continuation;    clinical practice;    retrospective;    DMARDs;    efficacy;    tolerance;   

DOI  :  

学科分类：医学（综合）

来源: Pacini Editore SpA

【 摘 要 】

OBJECTIVES: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:Study design: 3-year, retrospective, monocenter. Patients: 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. Analysis: 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.

【 授权许可】

Unknown