Leflunomide in the treatment of rheumatoid arthritis

Leflunomide is a new second-line drug for rheumatoid arthritis. This compound with long half-life inhibits proliferation of activated T lymphocytes. Phase III studies have demonstrated a clinical efficacy superior to placebo and identical to comparators (salazopyrine, methotrexate) with a faster onset of response. Improvement of inflammatory paramaters and functional capacity (HAQ) were observed as well as slowing of structural damage evaluated by X-rays. Global tolerance is fair, but possibility of hepatic involvement, although unfrequent, needs a regular survey.