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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Leflunomide in Takayasu arteritis - A long term observational study.

Alexandre Wagner Silva de Souza1, Renan de Almeida Agustinelli1, Hemerli de Cinque Almeida1

  • 1Divisão de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

Revista Brasileira De Reumatologia
|March 1, 2016
PubMed
Summary

Leflunomide therapy demonstrated sustained efficacy in Takayasu arteritis (TA) patients, with approximately half achieving remission at 12 months. The treatment was generally well-tolerated, indicating its potential for long-term management of TA.

Keywords:
Arterite de TakayasuLeflunomidaLeflunomideSystemic vasculitisTakayasu arteritisTherapyTratamentoVasculites sistêmicas

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Area of Science:

  • Rheumatology
  • Immunology
  • Internal Medicine

Background:

  • Takayasu arteritis (TA) is a rare, chronic inflammatory disease affecting large arteries.
  • Long-term treatment options for TA remain a significant clinical challenge.
  • Evaluating the sustained efficacy and safety of immunomodulatory drugs is crucial for TA management.

Purpose of the Study:

  • To assess the long-term efficacy and toxicity of leflunomide in Takayasu arteritis patients.
  • To extend the follow-up data from a previous short-term study of leflunomide in TA.
  • To identify factors influencing treatment outcomes in leflunomide-treated TA patients.

Main Methods:

  • An open-label, long-term longitudinal study was conducted.
  • Included TA patients met the 1990 American College of Rheumatology criteria.
  • Disease activity was assessed using Kerr's criteria and the Indian Takayasu Activity Score 2010 (ITAS2010).

Main Results:

  • Mean follow-up was 43.0±7.6 months.
  • 5 (41.6%) patients continued leflunomide; 7 (58.3%) switched due to relapse (6) or toxicity (1).
  • No significant differences in baseline characteristics or prednisone use were observed between groups.

Conclusions:

  • Leflunomide achieved sustained remission in approximately 50% of TA patients by 12 months.
  • The drug was well-tolerated, suggesting a favorable long-term safety profile.
  • Leflunomide represents a viable therapeutic option for long-term Takayasu arteritis management.