Leflunomide and Methotrexate
Many patients wonder if it safe to combine leflunomide and methotrexate during rheumatoid arthritis treatment.
Methotrexate has been used to treat RA for many years and is considered to the the major RA medication.
Leflunomide is known as a highly potent medication with a number of side effects and the ability to interact with other medications.
Leflunomide works by suppressing the immune system that attacks the patients’s own body cells by inhibiting dihydroorotate dehydrogenase, an enzyme involved in the production of DNA and RNA.
Methotrexate was originally used for cancer treatment. It works by altering the body’s use of folic acid (a vitamin), which is needed for the growth of “bad” cells.
Leflunomide vs Methotrexate
Many patients wonder which is more effective leflunomide or methotrexate.
Generally, methotrexate appears more effective in RA treatment than leflunimide and the latter is commonly used as an alternative or a part of a complex therapy when methotrexate fails. Not every patient seems to respond to methotrexate or tolerate it well and many of them show improvements after switching to leflunomide.
The effectiveness of these medications differs from patient to patient.
Specifically, in a study concerning the effectiveness of both these medications for juvenile rheumatoid arthritis (JRA) both these medications were found safe and more effective than the researchers expected. Specifically, response rate from methotrexate was 89% vs 68% from leflunomide, while the expected rates were 40% to 50%.
Leflunomide and Methotrexate Studies
The beneficial effect of methotrexate / leflunomide combination on active RA was confirmed in a number of studies.
A 24 week double-blind placebo-controlled trial involving 263 patients aged 18 to 75 was conducted in order to study the safety and effectiveness of the taking leflunomide with methotrexate in RA patients. Specifically, 130 patients were given combine treatment with methotrexate and leflunomide and 133 subjects were randomly placed on placebo and methotrexate. The study showed that the combined treatment was generally well tolerated and the improvement of RA in patients receiving the combined treatment was better than in those on methotrexate and placebo. For this reason,
the combination of leflunomide with methotrexate was suggested as a possible alternative for active RA patients where methotrexate fails to improve the disease.