Evaluation of radiographic progression in a subset of patients with RA treated with Arava beyond 2 years

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Ann Rheum Dis. 2004 Jun;63(6):737-9.

Long term evaluation of radiographic disease progression in a subset of

patients with rheumatoid arthritis treated with leflunomide beyond 2

years.

Van Der Heijde D, Kalden J, D, Smolen J, Strand V.

Division of Internal Medicine, Department of Rheumatology, University

Hospital Maastricht, 6202 AZ Maastricht, The Netherlands.

dhe@...

OBJECTIVES: To assess the effect of long term (>2 years) leflunomide

treatment on radiographic progression in patients with RA. METHODS:

Patients treated with leflunomide for >2 years in one of three phase III

trials and subsequent extensions, for whom paired, evaluable radiographs

at baseline and study end point were available, were included.

Radiographs of hands and feet were assessed according to the modified

Sharp/van der Heijde scoring method, for erosion, joint space narrowing,

and total score. Changes from baseline were assessed, and a predicted

yearly progression rate estimated for each patient. RESULTS: 128 of the

original 824 patients were included, with mean disease duration 5.1

years and mean leflunomide treatment duration 4.3 years until the final

x ray examination. The mean change from baseline in total score was 8.6

with yearly adjusted rate 1.9, and the median change was 2 with yearly

adjusted rate 0.5, compared with 7.9 and 4.9, respectively, before

leflunomide treatment. After treatment, the rate improved in 92/128

(72%) patients and deteriorated in 21/128 (16%). In 42 (33%) patients

who had a total score >0 at baseline, no radiographic progression

occurred after leflunomide treatment.

CONCLUSIONS: In a subset of patients who continued treatment long term,

leflunomide treatment reduced the rate of radiographic damage.

PMID: 15140783

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