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A Longterm Prospective Real-life Experience with Leflunomide in Juvenile Idiopathic Arthritis
To describe a clinical practice with leflunomide (LEF) in juvenile idiopathic arthritis (JIA). Patients with JIA seen between May 2008 and May 2012 and considered nonresponsive to methotrexate (MTX) were given LEF and prospectively followed. Primary outcome was a 28-joint Disease Activity Score (DAS...
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| Published in: | Journal of rheumatology 2014-02, Vol.41 (2), p.338-344 |
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| cites | cdi_FETCH-LOGICAL-c362t-c8b0c65171f4d50022ec9fe1c7cc3bfbe68db6bdfc76dbce4b23a16c125e99d93 |
| container_end_page | 344 |
| container_issue | 2 |
| container_start_page | 338 |
| container_title | Journal of rheumatology |
| container_volume | 41 |
| creator | DE CASTRO ALCANTARA, Antonia Célia CHAVES LEITE, Christiane Araújo MELO LEITE, Ana Caroline Rocha COSTA SIDRIM, José Julio SARAIVA SILVA, Francisco CASTRO ROCHA, Francisco Airton |
| description | To describe a clinical practice with leflunomide (LEF) in juvenile idiopathic arthritis (JIA).
Patients with JIA seen between May 2008 and May 2012 and considered nonresponsive to methotrexate (MTX) were given LEF and prospectively followed. Primary outcome was a 28-joint Disease Activity Score (DAS28) of low disease activity (< 3.2) in less than 6 months. Childhood Health Assessment Questionnaire (CHAQ) scores and safety data were recorded.
Forty-three patients (33 female) were included with 25 (58.1%) polyarticular, 10 oligoarticular (7 extended; 3 persistent), 6 systemic, and 2 enthesitis-related. Ten (23.2%) were rheumatoid factor-positive and 7 (16.3%) had antinuclear antibodies. Prior drugs other than MTX: 11 (25.5%) chloroquine diphosphate + MTX and 2 (4.6%) sulfasalazine + MTX; mean prednisone dose was 6.4 ± 9.3 mg. The MTX dose prior to LEF was 14.5 ± 4.5 mg/m(2)/week. LEF dose and duration of therapy were 16.6 ± 5.2 mg/d and 3.6 ± 2.2 years, respectively. Nineteen patients (44.2%) interrupted LEF: 1 entered remission, 11 were nonresponsive, and 7 were intolerant (16.2%). Baseline DAS28 (5.57 ± 0.7) dropped to 3.7 ± 1.2 at final analysis (p < 0.001) and 16 patients (37.2%) had a low DAS28 [< 3.2; 12 (27.9%) while taking LEF + MTX and 4 (9.3%) while taking monotherapy]. At last followup, the number of patients with DAS28 > 5.1 dropped from 34 (79%) to 9 (20.9%) and CHAQ scores from 0.86 ± 0.7 to 0.44 ± 0.5 (p < 0.001).
LEF isolated or combined with MTX is effective and safe to treat JIA in patients refractory to MTX. |
| doi_str_mv | 10.3899/jrheum.130294 |
| format | article |
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Patients with JIA seen between May 2008 and May 2012 and considered nonresponsive to methotrexate (MTX) were given LEF and prospectively followed. Primary outcome was a 28-joint Disease Activity Score (DAS28) of low disease activity (< 3.2) in less than 6 months. Childhood Health Assessment Questionnaire (CHAQ) scores and safety data were recorded.
Forty-three patients (33 female) were included with 25 (58.1%) polyarticular, 10 oligoarticular (7 extended; 3 persistent), 6 systemic, and 2 enthesitis-related. Ten (23.2%) were rheumatoid factor-positive and 7 (16.3%) had antinuclear antibodies. Prior drugs other than MTX: 11 (25.5%) chloroquine diphosphate + MTX and 2 (4.6%) sulfasalazine + MTX; mean prednisone dose was 6.4 ± 9.3 mg. The MTX dose prior to LEF was 14.5 ± 4.5 mg/m(2)/week. LEF dose and duration of therapy were 16.6 ± 5.2 mg/d and 3.6 ± 2.2 years, respectively. Nineteen patients (44.2%) interrupted LEF: 1 entered remission, 11 were nonresponsive, and 7 were intolerant (16.2%). Baseline DAS28 (5.57 ± 0.7) dropped to 3.7 ± 1.2 at final analysis (p < 0.001) and 16 patients (37.2%) had a low DAS28 [< 3.2; 12 (27.9%) while taking LEF + MTX and 4 (9.3%) while taking monotherapy]. At last followup, the number of patients with DAS28 > 5.1 dropped from 34 (79%) to 9 (20.9%) and CHAQ scores from 0.86 ± 0.7 to 0.44 ± 0.5 (p < 0.001).
LEF isolated or combined with MTX is effective and safe to treat JIA in patients refractory to MTX.</description><identifier>ISSN: 0315-162X</identifier><identifier>EISSN: 1499-2752</identifier><identifier>DOI: 10.3899/jrheum.130294</identifier><identifier>PMID: 24334641</identifier><identifier>CODEN: JRHUA9</identifier><language>eng</language><publisher>Toronto, ON: Journal of Rheumatology Publishing</publisher><subject>Adolescent ; Antirheumatic Agents - therapeutic use ; Arthritis, Juvenile - drug therapy ; Biological and medical sciences ; Bones, joints and connective tissue. Antiinflammatory agents ; Child ; Child, Preschool ; Diseases of the osteoarticular system ; Drug Therapy, Combination ; Female ; Health Status ; Humans ; Inflammatory joint diseases ; Isoxazoles - therapeutic use ; Male ; Medical sciences ; Methotrexate - therapeutic use ; Pharmacology. Drug treatments ; Prospective Studies ; Severity of Illness Index ; Surveys and Questionnaires ; Treatment Outcome</subject><ispartof>Journal of rheumatology, 2014-02, Vol.41 (2), p.338-344</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-c8b0c65171f4d50022ec9fe1c7cc3bfbe68db6bdfc76dbce4b23a16c125e99d93</citedby><cites>FETCH-LOGICAL-c362t-c8b0c65171f4d50022ec9fe1c7cc3bfbe68db6bdfc76dbce4b23a16c125e99d93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28275000$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24334641$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DE CASTRO ALCANTARA, Antonia Célia</creatorcontrib><creatorcontrib>CHAVES LEITE, Christiane Araújo</creatorcontrib><creatorcontrib>MELO LEITE, Ana Caroline Rocha</creatorcontrib><creatorcontrib>COSTA SIDRIM, José Julio</creatorcontrib><creatorcontrib>SARAIVA SILVA, Francisco</creatorcontrib><creatorcontrib>CASTRO ROCHA, Francisco Airton</creatorcontrib><title>A Longterm Prospective Real-life Experience with Leflunomide in Juvenile Idiopathic Arthritis</title><title>Journal of rheumatology</title><addtitle>J Rheumatol</addtitle><description>To describe a clinical practice with leflunomide (LEF) in juvenile idiopathic arthritis (JIA).
Patients with JIA seen between May 2008 and May 2012 and considered nonresponsive to methotrexate (MTX) were given LEF and prospectively followed. Primary outcome was a 28-joint Disease Activity Score (DAS28) of low disease activity (< 3.2) in less than 6 months. Childhood Health Assessment Questionnaire (CHAQ) scores and safety data were recorded.
Forty-three patients (33 female) were included with 25 (58.1%) polyarticular, 10 oligoarticular (7 extended; 3 persistent), 6 systemic, and 2 enthesitis-related. Ten (23.2%) were rheumatoid factor-positive and 7 (16.3%) had antinuclear antibodies. Prior drugs other than MTX: 11 (25.5%) chloroquine diphosphate + MTX and 2 (4.6%) sulfasalazine + MTX; mean prednisone dose was 6.4 ± 9.3 mg. The MTX dose prior to LEF was 14.5 ± 4.5 mg/m(2)/week. LEF dose and duration of therapy were 16.6 ± 5.2 mg/d and 3.6 ± 2.2 years, respectively. Nineteen patients (44.2%) interrupted LEF: 1 entered remission, 11 were nonresponsive, and 7 were intolerant (16.2%). Baseline DAS28 (5.57 ± 0.7) dropped to 3.7 ± 1.2 at final analysis (p < 0.001) and 16 patients (37.2%) had a low DAS28 [< 3.2; 12 (27.9%) while taking LEF + MTX and 4 (9.3%) while taking monotherapy]. At last followup, the number of patients with DAS28 > 5.1 dropped from 34 (79%) to 9 (20.9%) and CHAQ scores from 0.86 ± 0.7 to 0.44 ± 0.5 (p < 0.001).
LEF isolated or combined with MTX is effective and safe to treat JIA in patients refractory to MTX.</description><subject>Adolescent</subject><subject>Antirheumatic Agents - therapeutic use</subject><subject>Arthritis, Juvenile - drug therapy</subject><subject>Biological and medical sciences</subject><subject>Bones, joints and connective tissue. Antiinflammatory agents</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Diseases of the osteoarticular system</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Health Status</subject><subject>Humans</subject><subject>Inflammatory joint diseases</subject><subject>Isoxazoles - therapeutic use</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methotrexate - therapeutic use</subject><subject>Pharmacology. Drug treatments</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><subject>Surveys and Questionnaires</subject><subject>Treatment Outcome</subject><issn>0315-162X</issn><issn>1499-2752</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNpF0ctr3DAQwGERUpLN45hr0CWQi7d6WbaOy5InCw0hgV6Kkcejrha_Itnb5r-Pw27T01w-BuY3hFxwNpe5Md83YY1jM-eSCaMOyIwrYxKRpeKQzJjkacK1-HlMTmLcMMa10vkRORZKSqUVn5FfC7rq2t8DhoY-hS72CIPfIn1GWye1d0hv_vYYPLaA9I8f1nSFrh7brvEVUt_Sx3GLra-RPlS-6-2w9kAXYVgHP_h4Rr45W0c8389T8np787K8T1Y_7h6Wi1UCUoshgbxkoFOecaeqlDEhEIxDDhmALF2JOq9KXVYOMl2VgKoU0nINXKRoTGXkKbne7e1D9zZiHIrGR8C6ti12YyymKEqy6ehsosmOwnRtDOiKPvjGhveCs-KzaLErWuyKTv5yv3osG6y-9L-EE7jaAxvB1i7YFnz87_LpGYwx-QH5U4Fz</recordid><startdate>20140201</startdate><enddate>20140201</enddate><creator>DE CASTRO ALCANTARA, Antonia Célia</creator><creator>CHAVES LEITE, Christiane Araújo</creator><creator>MELO LEITE, Ana Caroline Rocha</creator><creator>COSTA SIDRIM, José Julio</creator><creator>SARAIVA SILVA, Francisco</creator><creator>CASTRO ROCHA, Francisco Airton</creator><general>Journal of Rheumatology Publishing</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140201</creationdate><title>A Longterm Prospective Real-life Experience with Leflunomide in Juvenile Idiopathic Arthritis</title><author>DE CASTRO ALCANTARA, Antonia Célia ; CHAVES LEITE, Christiane Araújo ; MELO LEITE, Ana Caroline Rocha ; COSTA SIDRIM, José Julio ; SARAIVA SILVA, Francisco ; CASTRO ROCHA, Francisco Airton</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-c8b0c65171f4d50022ec9fe1c7cc3bfbe68db6bdfc76dbce4b23a16c125e99d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Antirheumatic Agents - therapeutic use</topic><topic>Arthritis, Juvenile - drug therapy</topic><topic>Biological and medical sciences</topic><topic>Bones, joints and connective tissue. Antiinflammatory agents</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Diseases of the osteoarticular system</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Health Status</topic><topic>Humans</topic><topic>Inflammatory joint diseases</topic><topic>Isoxazoles - therapeutic use</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methotrexate - therapeutic use</topic><topic>Pharmacology. Drug treatments</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><topic>Surveys and Questionnaires</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DE CASTRO ALCANTARA, Antonia Célia</creatorcontrib><creatorcontrib>CHAVES LEITE, Christiane Araújo</creatorcontrib><creatorcontrib>MELO LEITE, Ana Caroline Rocha</creatorcontrib><creatorcontrib>COSTA SIDRIM, José Julio</creatorcontrib><creatorcontrib>SARAIVA SILVA, Francisco</creatorcontrib><creatorcontrib>CASTRO ROCHA, Francisco Airton</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of rheumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DE CASTRO ALCANTARA, Antonia Célia</au><au>CHAVES LEITE, Christiane Araújo</au><au>MELO LEITE, Ana Caroline Rocha</au><au>COSTA SIDRIM, José Julio</au><au>SARAIVA SILVA, Francisco</au><au>CASTRO ROCHA, Francisco Airton</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Longterm Prospective Real-life Experience with Leflunomide in Juvenile Idiopathic Arthritis</atitle><jtitle>Journal of rheumatology</jtitle><addtitle>J Rheumatol</addtitle><date>2014-02-01</date><risdate>2014</risdate><volume>41</volume><issue>2</issue><spage>338</spage><epage>344</epage><pages>338-344</pages><issn>0315-162X</issn><eissn>1499-2752</eissn><coden>JRHUA9</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>To describe a clinical practice with leflunomide (LEF) in juvenile idiopathic arthritis (JIA).
Patients with JIA seen between May 2008 and May 2012 and considered nonresponsive to methotrexate (MTX) were given LEF and prospectively followed. Primary outcome was a 28-joint Disease Activity Score (DAS28) of low disease activity (< 3.2) in less than 6 months. Childhood Health Assessment Questionnaire (CHAQ) scores and safety data were recorded.
Forty-three patients (33 female) were included with 25 (58.1%) polyarticular, 10 oligoarticular (7 extended; 3 persistent), 6 systemic, and 2 enthesitis-related. Ten (23.2%) were rheumatoid factor-positive and 7 (16.3%) had antinuclear antibodies. Prior drugs other than MTX: 11 (25.5%) chloroquine diphosphate + MTX and 2 (4.6%) sulfasalazine + MTX; mean prednisone dose was 6.4 ± 9.3 mg. The MTX dose prior to LEF was 14.5 ± 4.5 mg/m(2)/week. LEF dose and duration of therapy were 16.6 ± 5.2 mg/d and 3.6 ± 2.2 years, respectively. Nineteen patients (44.2%) interrupted LEF: 1 entered remission, 11 were nonresponsive, and 7 were intolerant (16.2%). Baseline DAS28 (5.57 ± 0.7) dropped to 3.7 ± 1.2 at final analysis (p < 0.001) and 16 patients (37.2%) had a low DAS28 [< 3.2; 12 (27.9%) while taking LEF + MTX and 4 (9.3%) while taking monotherapy]. At last followup, the number of patients with DAS28 > 5.1 dropped from 34 (79%) to 9 (20.9%) and CHAQ scores from 0.86 ± 0.7 to 0.44 ± 0.5 (p < 0.001).
LEF isolated or combined with MTX is effective and safe to treat JIA in patients refractory to MTX.</abstract><cop>Toronto, ON</cop><pub>Journal of Rheumatology Publishing</pub><pmid>24334641</pmid><doi>10.3899/jrheum.130294</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0315-162X |
| ispartof | Journal of rheumatology, 2014-02, Vol.41 (2), p.338-344 |
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| source | Medical Journals |
| subjects | Adolescent Antirheumatic Agents - therapeutic use Arthritis, Juvenile - drug therapy Biological and medical sciences Bones, joints and connective tissue. Antiinflammatory agents Child Child, Preschool Diseases of the osteoarticular system Drug Therapy, Combination Female Health Status Humans Inflammatory joint diseases Isoxazoles - therapeutic use Male Medical sciences Methotrexate - therapeutic use Pharmacology. Drug treatments Prospective Studies Severity of Illness Index Surveys and Questionnaires Treatment Outcome |
| title | A Longterm Prospective Real-life Experience with Leflunomide in Juvenile Idiopathic Arthritis |
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