Leflunomide as an option for RA treatment in questions and answers Review article
Article Sidebar
Published:
Mar 31, 2025
Keywords:
leflunomide, rheumatoid arthritis, polytherapy in RA, pregnancy in RA
Main Article Content
Abstract
Leflunomide is a drug recommended for the treatment of rheumatoid arthritis. The article discusses its place in therapy, drug dosage, conditions of reimbursement of the drug for the patient and precautions in case of procreation plans or pregnancy.
Article Details
How to Cite
Ligocki, P. (2025). Leflunomide as an option for RA treatment in questions and answers. Medycyna Faktow (J EBM), 18(1(66), 42-45. https://doi.org/10.24292/01.MF.0125.06
Issue
Section
Articles
Copyright © by Medical Education. All rights reserved.
References
1. Alldred A, Emery P. Leflunomide: a novel DMARD for the treatment of rheumatoid arthritis. Expert Opin Pharmacother. 2001; 2(1): 125-37.
2. Singh JA, Guyatt G, Ogdie A et al. Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Rheumatol. 2019; 71(1): 5-32.
3. Goldenberg MM. Leflunomide, a novel immunomodulator for the treatment of active rheumatoid arthritis. Clin Ther. 1999; 21(11): 1837-52.
4. Smolen JS, Landewé RBM, Bergstra SA et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease modifying antirheumatic drugs: 2022 update. Ann Rheum Dis. 2023; 82: 3-18.
5. Fox RI, Herrmann ML, Frangou CG et al. Mechanism of action for leflunomide in rheumatoid arthritis. Clin Immunol. 1999; 93(3): 198-208.
6. Munier-Lehmann H, Vidalain PO, Tangy F et al. On dihydroorotate dehydrogenases and their inhibitors and uses. J Med Chem. 2013; 56(8): 3148-67.
7. Madak JT, Bankhead A, Cuthbertson CR et al. Revisiting the role of dihydroorotate dehydrogenase as a therapeutic target for cancer. Pharmacol Ther. 2019; 195: 111-31.
8. Fox RI. Mechanism of action of leflunomide in rheumatoid arthritis. J Rheumatol Suppl. 1998; 53: 20-6.
9. Obwieszczenie Ministra Zdrowia z dnia 19 marca 2025 r. w sprawie wykazu refundowanych leków, środków spożywczych specjalnego przeznaczenia żywieniowego oraz wyrobów medycznych na 1 kwietnia 2025 r.
10. Yun H, Chen L, Xie F et al. Do patients with moderate or high disease activity escalate RA therapy according to treat-to-target principles? Results from the Rheumatology Informatics System for Effectiveness Registry of the American College of Rheumatology. Arthritis Care Res (Hoboken). 2020; 72: 166-75.
11. Smolen JS, Emery P, Kalden JR et al. The efficacy of leflunomide monotherapy in rheumatoid arthritis: towards the goals of disease modifying antirheumatic drug therapy. J Rheumatol Suppl. 2004; 71: 13-20.
12. Ważne informacje od Ministerstwa Zdrowia w kwestii refundacji.
13. Charakterystyka produktu leczniczego. LEFLUNOMID EGIS.
14. Oliveira RA, Fierro IM. New strategies for patenting biological medicines used in rheumatoid arthritis treatment. Expert Opin Ther Pat. 2018; 28(8): 635-46.
15. Wang Y, Tao S, Yu Z et al. Effect of moxibustion on β-EP and Dyn levels of pain-related indicators in patients with rheumatoid arthritis. Evid Based Complement Alternat Med. 2021; 2021: 8.
16. Shi J, Cui X, Wang Y et al. Study on the Mechanism of the Combination of Methotrexate and Leflunomide in the Treatment of Rheumatoid Arthritis Based on Network Pharmacology, Molecular Docking, and in vitro Experimental Verification. Comb Chem High Throughput Screen. 2024 Jun 20; doi: 10.2174/0113862073285626240604093210.
17. Bredemeier M, Ranza R, Kakehasi AM et al. Safety of the Methotrexate-leflunomide Combination in Rheumatoid Arthritis: Results of a Multicentric, Registry-based, Cohort Study (BiobadaBrasil). J Rheumatol. 2021; 48(10): 1519-27.
18. Pereira ICP, Sousa NCF, Pereira DMS et al. Treatment with either leflunomide or adalimumab reduces anaemia in patients with rheumatoid arthritis. An Acad Bras Cienc. 2018; 90(2 suppl 1): 2161-6.
19. Cutolo M, Bolosiu H, Perdriset G et al.; LEADER Study Group. Efficacy and safety of leflunomide in DMARD-naive patients with early rheumatoid arthritis: comparison of a loading and a fixed-dose regimen. Rheumatology (Oxford). 2013; 52(6): 1132-40.
20. Princk C, Kollhorst B, Haug U. Use of leflunomide among girls and women of childbearing age and occurrence of leflunomide-exposed pregnancies in Germany. ReprodToxicol. 2024; 125: 108573.
21. Stine JG, Lewis JH. Current and future directions in the treatment and prevention of drug-induced liver injury: a systematic review. Expert Rev Gastroenterol Hepatol. 2016; 10(4): 517-36.
2. Singh JA, Guyatt G, Ogdie A et al. Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Rheumatol. 2019; 71(1): 5-32.
3. Goldenberg MM. Leflunomide, a novel immunomodulator for the treatment of active rheumatoid arthritis. Clin Ther. 1999; 21(11): 1837-52.
4. Smolen JS, Landewé RBM, Bergstra SA et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease modifying antirheumatic drugs: 2022 update. Ann Rheum Dis. 2023; 82: 3-18.
5. Fox RI, Herrmann ML, Frangou CG et al. Mechanism of action for leflunomide in rheumatoid arthritis. Clin Immunol. 1999; 93(3): 198-208.
6. Munier-Lehmann H, Vidalain PO, Tangy F et al. On dihydroorotate dehydrogenases and their inhibitors and uses. J Med Chem. 2013; 56(8): 3148-67.
7. Madak JT, Bankhead A, Cuthbertson CR et al. Revisiting the role of dihydroorotate dehydrogenase as a therapeutic target for cancer. Pharmacol Ther. 2019; 195: 111-31.
8. Fox RI. Mechanism of action of leflunomide in rheumatoid arthritis. J Rheumatol Suppl. 1998; 53: 20-6.
9. Obwieszczenie Ministra Zdrowia z dnia 19 marca 2025 r. w sprawie wykazu refundowanych leków, środków spożywczych specjalnego przeznaczenia żywieniowego oraz wyrobów medycznych na 1 kwietnia 2025 r.
10. Yun H, Chen L, Xie F et al. Do patients with moderate or high disease activity escalate RA therapy according to treat-to-target principles? Results from the Rheumatology Informatics System for Effectiveness Registry of the American College of Rheumatology. Arthritis Care Res (Hoboken). 2020; 72: 166-75.
11. Smolen JS, Emery P, Kalden JR et al. The efficacy of leflunomide monotherapy in rheumatoid arthritis: towards the goals of disease modifying antirheumatic drug therapy. J Rheumatol Suppl. 2004; 71: 13-20.
12. Ważne informacje od Ministerstwa Zdrowia w kwestii refundacji.
13. Charakterystyka produktu leczniczego. LEFLUNOMID EGIS.
14. Oliveira RA, Fierro IM. New strategies for patenting biological medicines used in rheumatoid arthritis treatment. Expert Opin Ther Pat. 2018; 28(8): 635-46.
15. Wang Y, Tao S, Yu Z et al. Effect of moxibustion on β-EP and Dyn levels of pain-related indicators in patients with rheumatoid arthritis. Evid Based Complement Alternat Med. 2021; 2021: 8.
16. Shi J, Cui X, Wang Y et al. Study on the Mechanism of the Combination of Methotrexate and Leflunomide in the Treatment of Rheumatoid Arthritis Based on Network Pharmacology, Molecular Docking, and in vitro Experimental Verification. Comb Chem High Throughput Screen. 2024 Jun 20; doi: 10.2174/0113862073285626240604093210.
17. Bredemeier M, Ranza R, Kakehasi AM et al. Safety of the Methotrexate-leflunomide Combination in Rheumatoid Arthritis: Results of a Multicentric, Registry-based, Cohort Study (BiobadaBrasil). J Rheumatol. 2021; 48(10): 1519-27.
18. Pereira ICP, Sousa NCF, Pereira DMS et al. Treatment with either leflunomide or adalimumab reduces anaemia in patients with rheumatoid arthritis. An Acad Bras Cienc. 2018; 90(2 suppl 1): 2161-6.
19. Cutolo M, Bolosiu H, Perdriset G et al.; LEADER Study Group. Efficacy and safety of leflunomide in DMARD-naive patients with early rheumatoid arthritis: comparison of a loading and a fixed-dose regimen. Rheumatology (Oxford). 2013; 52(6): 1132-40.
20. Princk C, Kollhorst B, Haug U. Use of leflunomide among girls and women of childbearing age and occurrence of leflunomide-exposed pregnancies in Germany. ReprodToxicol. 2024; 125: 108573.
21. Stine JG, Lewis JH. Current and future directions in the treatment and prevention of drug-induced liver injury: a systematic review. Expert Rev Gastroenterol Hepatol. 2016; 10(4): 517-36.