Etanercept Superior to Leflunomide for Treating Arthritis

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Etanercept Superior to Leflunomide For Treating Arthritis

NEW YORK (Reuters Health) Aug 27 - In broad clinical experience in Sweden,

etanercept proved superior to leflunomide and probably infliximab for

treating rheumatoid arthritis, according to a report in the September issue

of ls of Rheumatic Diseases.

Rheumatoid arthritis often is treated with cytokine-modifying therapy with

tumor necrosis factor (TNF) blockade by etanercept or infliximab, or with

pyrimidine synthesis inhibitor leflunomide, the authors explain, but the

treatments have not been compared directly in open clinical trials involving

a broad spectrum of patients.

Dr. Pierre Geborek from University Hospital in Lund, Sweden and colleagues

at seven centers in southern Sweden, compared the three drugs in 404

treatments of 369 rheumatoid arthritis patients.

Treatment improvement (20% disease activity score improvement) was

significantly greater with etanercept than with infliximab or leflunomide at

3 and 6 months, the authors report.

Prednisolone dosages were significantly reduced with etanercept or

infliximab treatment, the report indicates, but not with leflunomide (except

in the small group of patients continuing treatment at least 12 months).

Moreover, discontinuation of treatment was significantly more common with

leflunomide than with either etanercept or infliximab, the researchers note,

though the rate of side effects appeared highest with infliximab.

" Efficacy data for the TNF blockers comply with results in clinical trials,

whereas leflunomide appeared to perform worse than in clinical trials, " the

authors conclude.

" Continued long term monitoring of the included patients and recruitment of

new patients into the protocol is necessary to enable full evaluation of the

spectrum of side effects, " the investigators add. " To identify rare side

effects, including specific types of malignancies, it is necessary to

combine data from this continuing protocol with data from other protocols

nationwide. "

Ann Rheum Dis 2002;61:793-798.