Leflunomide: friend or foe for systemic lupus erythematosus?

@article{Wu2013LeflunomideFO,
  title={Leflunomide: friend or foe for systemic lupus erythematosus?},
  author={Guo-Cui Wu and Xiao-Di Xu and Qiong Huang and Huaxun Wu},
  journal={Rheumatology International},
  year={2013},
  volume={33},
  pages={273-276}
}
Leflunomide is a new immunosuppressive medicine that has been effectively used in the therapy of rheumatoid arthritis and subsequently used with success in animal models and patients with systemic lupus erythematosus (SLE). However, its use has also been associated with significant and serious adverse reactions involving hematological, hepatic, immune, dermatological and respiratory systems. In the current review, we attempt to describe the two sides of this drug in the treatment of SLE. 

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  • 2013
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References

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The successful treatment of two lupus patients with leflunomide is described and the current literature is reviewed to help clarify the drug's role in the treatment of rheumatoid arthritis.

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Vasculitis Occurring during Leflunomide Therapy

A patient treated with leflunomide who developed vasculitis as an adverse side effect is reported, which is the first published report of vasculopathy associated with le flunomid therapy.

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A skin eruption consistent with subacute cutaneous lupus erythematosus (SCLE) occurred in a patient taking leflunomide for rheumatoid arthritis, and suppression of tumor necrosis factor (TNF)-effector mechanisms by leflinomide may have played a role in the pathogenesis of this disorder.

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Clinicians should exclude pulmonary disease prior to initiating leflunomide treatment in patients with RA on the basis of a thorough history and physical examination, and chest radiograph.

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A female patient with rheumatoid arthritis who had been treated with systemic steroids and methotrexate for 2 years is one of the few cases of severe drug reaction after intake of leflunomide, and the indication of this relatively new drug should be considered carefully.

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A 49-year-old Japanese man with rheumatoid arthritis acutely developed a skin eruption and severe non-productive cough seventeen days after the administration of leflunomide and finally died of respiratory failure 128 days afterThe onset of acute interstitial pneumonia.