Efficacy and safety of leflunomide or methotrexate plus subcutaneous tumour necrosis factor-alpha blocking agents in rheumatoid arthritis

Maurizio Benucci, G. Saviola, P. Baiardi, M. Manfredi, P. Sarzi-Puttini, F. Atzeni

Research output: Contribution to journalArticlepeer-review

Abstract

Several smaller retrospective case series have concluded that leflunomide (LEF) in combination with anti-TNF-α blocking agents appears to be effective and safe. Prospective case series and cohort studies have generally confirmed the efficacy of this combination. Overall, there is currently no evidence from controlled trials that an anti-TNF-α combination with LEF is as effective as an anti-TNF-α combination with methotrexate (MTX). We compared the effectiveness and safety of a therapeutic regimen associating subcutaneous anti-TNF-á agents, etanercept (ETN) and adalimumab (ADA), with leflunomide (LEF) or methotrexate (MTX), in a two year open-label study performed in clinical practice. We evaluated 96 patients with active rheumatoid arthritis undergoing therapy with ADA at the dose of 40 mg every other week, or with ETN at the dose of 50 mg/week for two years added to prednisolone (PDN) at the mean dose of 5.2±2.6 mg/day. Fifty-four of these patients were also undergoing therapy with MTX at the mean dose of 11.7±2.6 mg/week, while 42 patients were undergoing therapy with LEF at the daily dose of 20 mg. At 12 months, the analysis of variance showed an improvement of DAS28 in both groups (p

Original languageEnglish
Pages (from-to)269-274
Number of pages6
JournalInternational Journal of Immunopathology and Pharmacology
Volume24
Issue number1
Publication statusPublished - Jan 2011

Keywords

  • Anti-TNF agents
  • Leflunomide
  • Methotrexate
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Pharmacology
  • Immunology
  • Immunology and Allergy

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