Leflunomide treatment in corticosteroid-dependent myasthenia gravis: an open-label pilot study

J Neurol. 2016 Jan;263(1):83-8. doi: 10.1007/s00415-015-7944-8. Epub 2015 Oct 29.

Abstract

Leflunomide is an effective drug used in the treatment of rheumatoid arthritis. Here we report the findings of an open-label pilot study, which found that leflunomide is also an effective treatment for myasthenia gravis (MG). This study recruited 15 corticosteroid-dependent MG patients. For 6 months, leflunomide 20 mg was given to these patients daily along with prednisone. The quantitative myasthenia gravis (QMG) scores and MG activities of daily living (MG-ADL) profiles were measured in these MG patients. After 6 months of treatment, 9 of the 15 patients enrolled in this study showed improvements in both QMG and MG-ADL. The mean QMG scores (13.4 to 8.5) and MG-ADL profiles (5.8 to 2.8) were significantly decreased (P = 0.01, 0.006 respectively). Furthermore, we found that the mean corticosteroid doses were reduced after treatment with leflunomide (24.3 to 12.3 mg per day). Leflunomide is a well-tolerated and efficacious treatment for corticosteroid-dependent MG, which may also enable lower doses of corticosteroids to be administered.

Keywords: ADL; Corticosteroid-dependent; Leflunomide; Myasthenia gravis; QMG.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Adolescent
  • Adult
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / pharmacology*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / pharmacology*
  • Isoxazoles / administration & dosage
  • Isoxazoles / pharmacology*
  • Leflunomide
  • Male
  • Middle Aged
  • Myasthenia Gravis / drug therapy*
  • Pilot Projects
  • Prednisone / administration & dosage
  • Prednisone / pharmacology
  • Treatment Outcome
  • Young Adult

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Isoxazoles
  • Leflunomide
  • Prednisone