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[Leflunomide-related severe axonal neuropathy].
A Gabelle1, J C Antoine, D Hillaire-Buys
1Service d'Explorations Neurologiques et d'Epileptologie, Hôpital Gui-de-Chauliac, Montpellier. audreygabelle@hotmail.com
Revue Neurologique
|November 17, 2005
Summary
Leflunomide, used for rheumatoid arthritis, may cause severe sensory-motor axonal polyneuropathy. Discontinuation of leflunomide led to symptom improvement in patients, suggesting a causal link.
Area of Science:
- Neurology
- Rheumatology
- Pharmacology
Background:
- Leflunomide is a disease-modifying antirheumatic drug (DMARD) used for rheumatoid arthritis.
- Its mechanism involves inhibiting lymphocyte proliferation.
- This study investigates a potential adverse effect of leflunomide treatment.
Observation:
- Two patients, aged 61 and 70, developed sensory-motor axonal polyneuropathy.
- Symptom onset occurred approximately 5 months after initiating leflunomide therapy.
- Initial etiological investigations for the neuropathy were inconclusive.
Findings:
- Withdrawal of leflunomide resulted in rapid improvement of neurological symptoms in both cases.
- A review of drug watch data identified 12 additional cases of leflunomide-associated neuropathy.
- The majority of reported cases (10/12) involved patients over 60 years old, with a mean onset of 9 months.
Implications:
- Leflunomide is strongly implicated as a causative agent of axonal sensory-motor neuropathy.
- The findings highlight the importance of monitoring for neurological adverse events in patients treated with leflunomide.
- Further research is needed to determine the prevalence of leflunomide-induced neuropathy.