Leflunomide in rheumatoid arthritis in daily practice: treatment discontinuation rates in comparison with other DMARDs

Clin Exp Rheumatol. Mar-Apr 2006;24(2):168-71.

Abstract

Objective: To evaluate the treatment discontinuation rate of leflunomide in rheumatoid arthritis (RA) in comparison with the discontinuation of other disease modifying anti-rheumatic drugs (DMARDs), in daily practice, in a single center and during the same period of time.

Study design: 3-year, retrospective, monocenter.

Patients: RA patients for whom leflunomide or another DMARD was initiated between 1998 and 2001 (several DMARDs could be initiated for a given patient during this period). Collected data: For each patient, demographic and disease data. For each treatment course, date of initiation, if relevant date of discontinuation and reason for discontinuation.

Analysis: Percentage of patients discontinuing treatment over time (life table method; Kaplan-Meier), comparison between leflunomide and the "any other DMARD" or methotrexate groups using the Log-Rank test.

Results: During the study period, 515 DMARDs were initiated in 285 patients. Leflunomide was initiated in 161 patients who were older and had a longer disease duration than the other treated patients (59 +/- 13 years and 14 +/- 9 years versus 54 +/- 15 years and 11 +/- 10 years in the leflunomide group and other DMARDs group respectively). Discontinuation rate of leflunomide after 1 year was 56.7%, mainly because of adverse drug reactions (41.6%). The discontinuation rate whatever the reason and for toxicity was higher for leflunomide than for other DMARDs studied. However discontinuation for inefficacy was similar in both groups.

Conclusion: This study conducted in conditions of daily practice when leflunomide was first available suggests a higher discontinuation rate of leflunomide because of adverse events when compared to other DMARDs.

Publication types

  • Comparative Study

MeSH terms

  • Adjuvants, Immunologic / therapeutic use*
  • Antirheumatic Agents / therapeutic use*
  • Female
  • Humans
  • Isoxazoles / therapeutic use*
  • Leflunomide
  • Male
  • Middle Aged
  • Patient Dropouts / statistics & numerical data*
  • Retrospective Studies
  • Time Factors
  • Treatment Failure
  • Treatment Refusal / statistics & numerical data*

Substances

  • Adjuvants, Immunologic
  • Antirheumatic Agents
  • Isoxazoles
  • Leflunomide