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Leflunomide for chronic sarcoidosis.
Robert P Baughman1, Elyse E Lower
1Interstitial Lung Disease and Sarcoidosis Clinic, University of Cincinnati Medical Center, Cincinnati, Ohio, USA. bob.baughman@uc.edu
Summary
Leflunomide is a well-tolerated and effective treatment for chronic sarcoidosis, offering an alternative to methotrexate with reduced toxicity. This study shows promising results for sarcoidosis patients.
Area of Science:
- Immunology
- Rheumatology
- Pulmonology
Background:
- Leflunomide (Arava) is a cytotoxic drug used for rheumatoid arthritis.
- It shows potentially lower toxicity compared to methotrexate.
- Systematic evaluation of leflunomide for sarcoidosis is lacking.
Purpose of the Study:
- To evaluate the efficacy and toxicity of leflunomide in sarcoidosis patients.
- To compare leflunomide with methotrexate as a treatment for sarcoidosis.
- To assess leflunomide as an alternative for patients intolerant to methotrexate.
Main Methods:
- Retrospective review of patient records from a tertiary sarcoidosis center (July 2002-July 2003).
- Analysis of efficacy and toxicity data for patients treated with leflunomide or methotrexate.
- Inclusion of patients treated with leflunomide alone or in combination with methotrexate.
Main Results:
- Thirty-two patients received leflunomide; 15 received it with methotrexate.
- Common indications included ocular and lung sarcoidosis.
- Response rates were high for both leflunomide alone (12/17) and with methotrexate (13/15).
- Leflunomide was generally well-tolerated, with nausea being the most common side effect leading to discontinuation in three patients.
- Seventeen patients switched to leflunomide due to methotrexate toxicity.
Conclusions:
- Leflunomide demonstrates good tolerability in chronic sarcoidosis.
- It appears to be as effective as methotrexate with a better toxicity profile.
- Leflunomide is a viable alternative treatment for sarcoidosis patients unable to tolerate methotrexate.