Re: Incidence of Infections Associated With Leflunomide (Arava)

[Guest guest]

I wonder if there are any studies of the incidences of

infections following treatment with Arava. I was Arava

for about a year and a half I went off of it April

2006. I am sick all the time. Last year alone I had

three bouts with strep, two sinus infections, and

bronchitis that lasted a month. The new year ended

with a four day bout with the stomach flu and

immediately following I now have a cold. I'm not even

on treatment anymore but I am always sick. It would be

interesting to see how long it takes the immune system

to recover following treatment with all these meds. I

used to have a WBC around 6 or 7. In the last three

years my WBC has never gone over 5 and usually stays

around 4.0-4.1.

--- Georgina <gmckin11@...> wrote:

> Incidence of Infections Associated With Leflunomide

> for RA " Acceptable "

> J Rheumatol 2007;34:2201-2203.

> http://www.medscape.com/viewarticle/567910?src=mp

>

> NEW YORK (Reuters Health) - Among patients with

> rheumatoid arthritis (RA) in

> New Zealand, the rate of serious infection

> associated with leflunomide

> treatment is " acceptable in the context of optimally

> treating active RA, "

> report Dr. T. Chapman of Christchurch Hospital

> and colleagues in the

> November issue of the Journal of Rheumatology.

>

> They note that the government did not fund a

> TNF-blocker in New Zealand

> until 2006, and treatment of RA has relied on

> disease modifying

> antirheumatic drugs. Leflunomide was rarely used

> until 2002, when it

> received funding.

>

> The team conducted an audit of all 171 RA patients

> who initiated leflunomide

> therapy at Christchurch Hospital between 2002 and

> 2006. The patients took an

> average of 16.8 mg of leflunomide daily for an

> average of 23.4 months.

>

> According to the investigators, 11 patients

> developed severe infections

> requiring hospitalization while taking leflunomide,

> yielding an incidence of

> severe infection of 3.30 per 100 patient-years. This

> is similar to a recent

> audit from the UK comparing DMARD-treated and

> anti-TNF-treated patients, Dr.

> Chapman and colleagues note.

>

> Among the 11 patients with severe infections, three

> developed lower

> respiratory tract infections, two developed

> cellulitis, two had disseminated

> herpes zoster, and one each developed probable

> hepatic TB, abdominal sepsis,

> mycotic aneurysm, and gastroenteritis.

>

> Patients with severe RA and those taking concomitant

> methotrexate and

> corticosteroids were at greatest risk for severe

> infection, the researchers

> found. Nine of the 11 patients who developed severe

> infections were taking

> corticosteroids or corticosteroids with methotrexate

> simultaneously with

> leflunomide.

>

> In addition to these 11 cases, the New Zealand

> Pharmacovigilance Centre has

> been notified of 7 additional reports of severe

> infections in RA patients

> taking leflunomide, the authors note in their

> report, including probable

> pulmonary TB (1), pneumocystis pneumonia (1), other

> pulmonary infection (2),

> and septicemia (3) including a case of infective

> endocarditis.

>

> Four of these infections occurred in patients taking

> leflunomide in

> combination with methotrexate and one in combination

> with adalimumab. All

> five of these patients were also taking

> corticosteroids.

>

> While they believe the risk of serious infection is

> acceptable, Dr. Chapman

> and colleagues also report that " in our experience,

> once established,

> infections may rapidly progress in patients with RA

> taking leflunomide. "

> Therefore, " early cholestyramine washout is strongly

> recommended, " they

> write.

>

>

________________________________________________________________________________\

____

Be a better friend, newshound, and

know-it-all with Mobile. Try it now.

http://mobile./;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ