Vasculitis & polymyalgia rheumatica
Efficacy and safety of leflunomide in the management of large vessel vasculitis: A systematic review and metaanalysis of cohort studies
Authors' conclusion
LEF is well tolerated and might be effective for patients with TAK and GCA.
Study context
- Population
- Patients with large vessel vasculitis (LVV) (Takayasu arteritis and giant cell arteritis (GCA)) treated with leflunomide8 studies TAK, 7 GCA
- Comparison
- TAK vs GCA
- Outcome
- Efficacy (remission) and safety of LEF in LVV
Methodological detailsrandom-effects meta-analysis, uncontrolled observational studies
- Random-effects meta-analysis
- Uncontrolled observational studies
Pooled result
As reported in the abstract
At least partial remission (pooled proportion)
Further pooled results
Angiographic stabilization in TAK, pooled proportion
- TAK: angiographic stabilization
- 86% (0.77-0.94)
Relapses in TAK, pooled proportion
- TAK: relapses
- 12% (0.05-0.21)
Mean reduction in prednisolone dose (mean reduction in the prednisolone dose (MRPD)) after leflunomide (LEF) in TAK
- TAK: MRPD
- 15.7 mg/d (10.28-21.16)
LEF vs methotrexate (MTX) or cyclophosphamide in TAK
- LEF superior in remission induction, relapse prevention and tolerance
LEF vs tofacitinib in TAK
- Comparable efficacy
MRPD after LEF in GCA
- GCA: MRPD
- 15.63 mg/d (1.29-32.55)
GC discontinuation in GCA, pooled proportion
- GCA: able to discontinue GC
- 53% (0.25 - 0.80)
Relapses in GCA, pooled proportion of cases
- GCA: relapses
- 21% (0.14- 0.28)
LEF vs MTX in GCA
- Similar efficacy and tolerance
Safety
Adverse events in TAK, pooled proportion of patients
- TAK: adverse events
- 8% (0.02-0.16)
Adverse events in GCA, pooled proportion
- GCA: adverse events
- 28% (0.12-0.46)
Original publication
Efficacy and safety of leflunomide in the management of large vessel vasculitis: A systematic review and metaanalysis of cohort studies. Semin Arthritis Rheum. Published 11 January 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →