THE EFFICACY OF COMBINATION LEFLUNOMIDE AND METHOTREXATE (MTX) THERAPY FOR PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS

Dr. Utpal Kumar Chanda*, Dr. Pritish Tarafder, Dr. Sk. Moazem Hossain and Dr. Shailendranath Biswas

ABSTRACT

Background: Rheumatoid arthritis (RA) is a progressive inflammatory disease of unknown etiology that causes mortality. In recent days it was found that, methotrexate (MTX) combined with leflunomide (LEF) demonstrated a substantial incremental benefit in patients with RA. Objective: In the study our main aim is to evaluate the Outcome of Combination leflunomide and methotrexate (MTX) therapy for patients with active rheumatoid arthritis. Method: This cross sectional study was carried out at tertiary medical hospital from February 2021 to February 2022. Where a total of 200 patients of Rheumatoid Arthritis were attended OPD were included as a sample size. During the study patients were divided into two group, placebo + MTX, n=100, whereas patients randomized to LEF and MTX continued treatment [(LEF/LEF) + MTX], n=100, were used as another group. Results: During the study, majority were belonging to 45-55 years age group, 65% and 85% were male. In the patients who switched from PLA to LEF therapy while taking background MTX, the ACR20 responder-at-endpoint rate was 25.0% at Week 24, which increased to 59.4% at Week 48, and was statistically different (p < 0.0001). in addition, there was a further improvement in the mean change in HAQ DI at Week 48 (–0.33) compared with that seen at Week 24. In Placebo+MTX group events like diarrhea, nausea, gastroenteritis, vomiting, sore mouth, UTI, hypotension were higher than LEF+MTX. Conclusion: The therapeutic advantage of combination LEF + MTX for the treatment of RA in patients with active illness receiving MTX alone was maintained for 48 weeks, including improvements in signs and symptoms (ACR response), physical function (HAQ DI).

Keywords: Rheumatoid arthritis (RA), meth'otrexate (MTX), leflunomide (LEF).