Leflunomide: friend or foe for systemic lupus erythematosus?

  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},
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. 

Which dose of steroids and which cytotoxics for severe lupus?

Systemic lupus erythematosus: a therapeutic challenge for the XXI century

Current therapeutic options for SLE patients and the state of the art of investigational drugs targeting pathogenic pathways identified in these patients are addressed.

Efficacy of leflunomide in the treatment of palindromic rheumatism

The goal of treatment in palindromic rheumatism (PR) is to control the attacks and prevent disease evolution to chronic arthritis. Conventional synthetic disease‐modifying antirheumatic drugs

Erythema multiforme‐like drug eruption in a patient with systemic lupus erythematosus treated with leflunomide

A 28-year-old woman with SLE treated with leflunomide presented with acute-onset erythematous macules involving her neck, trunk, and limbs and completely recovered in 3 weeks, only leaving little hyperpigmentation.

Is there an effective treatment for late-onset systemic lupus erythematosus?

Treating patients with late-onset lupus can be more difficult due to the risk of drug–drug interactions and aging-related processes, and antimalarials should be used whenever possible, and glucocorticoids and immunosuppressive drugs must used be carefully.

Current and emerging treatment options in the management of lupus

The importance of managing comorbidities such as cardiovascular risk factors, bone health, and minimizing susceptibility to infection should not be neglected.

The beneficial effect of leflunomide on systemic lupus erythematosus: the role of Tregs repopulation?

  • J. Shin
  • Biology, Medicine
    Rheumatology International
  • 2013
It is speculated that leflunomide might treat SLE by repopulating Tregs in addition to the suppressing inflammatory cytokines and the exact molecular role of T Regs in the pathogenesis in SLE development should be further elucidated in the future.

Efficacy of leflunomide combined with prednisone in the treatment of refractory nephrotic syndrome

LEF combined with prednisone has a certain efficacy on the RNS and displays few adverse reactions and a large-sample, randomized double-blind controlled study and long-term follow-up are needed to verify the efficacy of leflunomide combined withprednisone.

The Selective Oral Immunomodulator Vidofludimus in Patients with Active Rheumatoid Arthritis: Safety Results from the COMPONENT Study

The COMPONENT study yielded important safety and pharmacokinetic data that could provide important information regarding the use of vidofludimus in other clinical trials, not only for RA but also for other autoimmune diseases.



[Leflunomide in systemic lupus erythematosus].

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.

Lupus erythematosus with leflunomide: induction or reactivation?

The relationship between induced lupus and leflunomide was confirmed by the resolution of the skin rash when the drug was stopped and its recurrence when it was reintroduced following a dose-response effect.

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.

Leflunomide in subacute cutaneous lupus erythematosus – two sides of a coin

This work has shown that leflunomide, a novel antirheumatic drug, has shown efficacy in the treatment of systemic lupus erythematosus in pilot studies.

Subacute cutaneous lupus erythematosus associated with leflunomide.

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.

Pseudo-pseudo Meigs syndrome developed under the leflunomide therapy

This is the first case of Tjalma syndrome that is developed in normal renal functions and the probable role of leflunomide therapy is discussed.

Leflunomide induced acute interstitial pneumonia.

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.

[Treatment of proliferative lupus nephritis with leflunomide and steroid: a prospective multi-center controlled clinical trial].

LEF combined with steroid was effective in the induction therapy of proliferative lupus nephritis and was generally well-tolerated, its efficacy in maintenance therapy and long-term safety remains to be clarified.

Erythema multiforme-Like Drug Eruption with Oral Involvement after Intake of Leflunomide

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.

Rheumatoid arthritis complicated with acute interstitial pneumonia induced by leflunomide as an adverse reaction.

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.