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Rheumatoid Arthritis Drug, Leflunomide, May Aid Resistant Psoriatic Arthritis

A drug recently approved for the treatment of rheumatoid arthritis may prove to be a useful agent for recalcitrant cases of psoriasis and psoriatic arthritis.

Until now, the role of leflunomide in the treatment of psoriasis and psoriatic arthritis has not been clarified, although the drug is indicated for rheumatoid arthritis treatment.

Participants in this study were 12 consecutive psoriatic arthritis patients who had not responded to at least one disease modifying anti-rheumatic drug (DMARD). All of the patients were started on leflunomide alone or in combination with another DMARD.

Global assessment of improvement in psoriasis and psoriatic arthritis by the treating rheumatologist was scored on a zero-to-three scale.

Doctors found that after two to three months of treatment, eight of the patients had moderate to marked improvement in both psoriasis and psoriatic arthritis.

The improvement in modified tender joint counts, patient's global assessments and grip strengths was found to be statistically significant. The doctors' global assessments and the modified swollen joint counts, however, did not reach a significant difference.

Three patients whose toxicity necessitated the temporary discontinuation of the drug were able to resume the drug at lower dosage with clinical benefit.

Thus, leflunomide may prove to be useful for the treatment of recalcitrant cases of psoriasis and psoriatic arthritis, these authors conclude.

This clinical study was undertaken by George C. Liang and Walter G. Barr from the Division of Rheumatology, Department of Medicine, Northwestern University Medical School, Chicago, Illinois.
JCR: Journal of Clinical Rheumatology 2001;7:366-370. "Open Trial of Leflunomide for Refractory Psoriasis and Psoriatic Arthritis"

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