RESEARCH - Effect of Arava on the peripheral nerves in RA

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Intern Med J. 2007 Feb;37(2):101-7.

Effect of leflunomide on the peripheral nerves in rheumatoid arthritis.

s BL, Spies J, McGill N, s GW, Vaile J, Bleasel JF, Youssef PP.

Department of Rheumatology, The Royal Prince Alfred Hospital, Sydney,

NSW, Australia.

BACKGROUND: The objective of this study was to determine the

neurophysiological effects of leflunomide on peripheral nerves in

rheumatoid arthritis. METHODS: We conducted a prospective cohort trial

of 32 patients with rheumatoid arthritis with 16 patients receiving

leflunomide treatment and 16 receiving other disease-modifying

anti-rheumatic drug therapies. Clinical, laboratory and

neurophysiological measurements were used to determine the presence of

a peripheral neuropathy in these patients at study entry and then

after a further 3 and 6 months. RESULTS: Fifty-four per cent of the

leflunomide group and 8% of the control group had an increase in their

neuropathy symptom score 6 months into the study (P = 0.01). No

correlation was found between the electrophysiological findings and

the clinical symptoms. There was no significant difference between the

two groups in upper and lower limb sensory and motor amplitudes and

conduction velocities recorded at 3 and 6 months. One patient

developed both clinical and neurophysiological evidence of a

peripheral neuropathy 5 months into the study that improved after

cessation of leflunomide therapy and cholestyramine washout.

CONCLUSION: After 6 months of exposure we found that leflunomide was

associated with an apparent increase in the clinical symptoms of

peripheral neuropathy in patients with rheumatoid arthritis. These

symptoms did not correlate with neurophysiological studies.

PMID: 17229252

http://www.ncbi.nlm.nih.gov/pubmed/17229252

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