Plain language summary
Leflunomide for the treatment of rheumatoid arthritis
This summary of a Cochrane review presents what we know from research about the effect of Leflunomide on rheumatoid arthritis. The review shows that in people with rheumatoid arthritis:
- Leflunomide probably improves pain.
-Leflunomide improves number of tender or swollen joints and other outcomes such as pain and disability.
- Leflunomide causes side effects such as diarrhea, upset stomach, elevated liver function tests, and allergic reactions. We often do not have precise information about side effects and complications. This is particularly true for rare but serious side effects.
What is rheumatoid arthritis and what is Leflunomide?
When you have rheumatoid arthritis, your immune system, which normally fights infection, becomes over-active and attacks the lining of your joints. This makes your joints swollen, stiff and painful. The small joints of your hands and feet are usually affected first. There is no cure for rheumatoid arthritis at present, so the treatments aim to relieve pain and stiffness and improve your ability to move.
Leflunomide is a disease-modifying antirheumatic drug (DMARD). It works by stabilizing the over-active cells in the immune system that cause inflammation in the joints. Reducing the inflammation can prevent damage to the joints. Leflunomide is taken in pill form. It costs more than other DMARDs, so doctors usually prescribe it if other DMARDs haven’t worked well.
Best estimate of what happens to people with rheumatoid arthritis who take Leflunomide after 6 months:
Pain (higher scores mean worse or more severe pain)
- People who took Leflunomide rated their pain to be10 points lower on a scale of 0 to 100 with Leflunomide (10% absolute improvement). This may be due to chance.
- People who took Leflunomide rated their pain to be about 14 points lower on a scale of 0 to 100.
- People who took a placebo rated their pain to be about 4 points lower on a scale of 0 to 100.
ACR 50 (number of tender or swollen joints and other outcomes such as pain and disability).
- 19 people out of 100 who took a placebo experienced improvement. (19% absolute improvement)
- 33 more people out of 100 experienced improvement in the symptoms of their rheumatoid arthritis with Leflunomide
- 14 people out of 100 experienced improvement in the symptoms of their rheumatoid arthritis with a placebo.
- 10 more people who took Leflunomide dropped out from the trial because of side effects. (10% absolute difference)
- 16 people out of 100 who took Leflunomide dropped out from the trial because of side effects
- 6 people out of 100 who used a placebo dropped out from the trial because of side effects.