Efficacy and safety of leflunomide treatment in Takayasu arteritis: Case series from the East China cohort

作者：Xiaomeng Cui, Xiaomin Dai, Lili Ma, Chengde Yang, Wenfeng Tan, Liyun Zhang, Zhenchun Zhang, Xuebing Feng, Rui Wu, Yaohong Zou, Zhenyuan Zhou, Yu Lu, Youlian Wang, Min Wu, LI Su-pin, Ling Wang, He Lin, Zhihui Dong, Weiguo Fu, Xiaoning Sun, Chunsheng Wang, Jing Ding, Peng Lv, Jiang Lin, Lindi Jiang · 发表于：Seminars in Arthritis and Rheumatism · 年份：2019 · DOI：10.1016/j.semarthrit.2019.06.009 · 被引用次数：26 · 研究领域：Vasculitis and related conditions、Renal Diseases and Glomerulopathies、Rheumatoid Arthritis Research and Therapies

OBJECTIVE: To evaluate the efficacy and safety of leflunomide (LEF) as induction treatment in a series of Takayasu arteritis (TA) patients based on a Chinese cohort. METHOD: Fifty-six patients from the East China TA cohort treated with LEF for at least 3 months were enrolled in this study, including the naïve LEF treatment patients (n = 41) and the cyclophosphamide (CYC)-resistant LEF treatment patients (n = 15). Data in clinical features, NIH score and angiography were collected. Response to treatment was assessed by rates of complete remission (CR) and partial remission (PR) and response rate (RR) after 6 and 12 months of treatment. RESULTS: The total CR rate and RR were 67.86% and 83.93% after 6 months, and 55.36% and 69.64% after 12 months, respectively. ESR and CRP levels and NIH scores decreased significantly after 12 months of LEF treatment (P < 0.05). Patients of CYC-resistant switched to LEF and reached the CR of 60.00% (9/15) and RR of 86.67% (13/15) after 6 months, and 73.33% (11/15) and 80.00% (12/15) after 12 months, respectively, with decrease in NIH scores (all P < 0.05). After following up for 14.44 ± 6.86 months, 48 patients (85.71%) continued LEF treatment with good tolerance. One patient died from progression of TA after 2 months, 2 patients relapsed, and 3 patients with side effects were switched to other immunosuppressive agents. CONCLUSIONS: LEF led to a quick induction and sustained remission of TA, especially in refractory cases, and therefore, should ...