In a nutshell
This study examined the effectiveness and safety of tocilizumab and leflunomide combination therapy.
Some background
Methotrexate (Trexall) is a drug used to treat patients with rheumatoid arthritis (RA). Methotrexate is often combined with a biological therapy (drugs that block the immune system) such as tocilizumab (Actemra). This combination is believed to have greater outcomes for patients. However, methotrexate is not well tolerated by some patients. Leflunomide (Arava) is an alternative to methotrexate and has similar effectiveness. It’s not known whether a combination of leflunomide and tocilizumab is safe and effective.
Methods & findings
This study aimed to compare the effectiveness and safety of tocilizumab in combination with leflunomide or methotrexate.
This study involved 91 RA patients divided into two groups. In group 1, 29 patients received leflunomide and tocilizumab for 6 months. In group 2, 62 patients received methotrexate and tocilizumab for 6 months.
Disease activity (number of affected joints) and functional disability (ability to perform daily activities) improved in all patients. There was no difference in disease activity or functional disability in patients after 6 months.
54% of participants experienced one or more side effects such as infections. 10% of patients in group 2 discontinued treatment due to serious side effects. 11% of patients in group 1 discontinued treatment due to serious side effects.
The bottom line
This study concluded that leflunomide is a safe and effective alternative to methotrexate in combination with tocilizumab.
The fine print
The sample size used in both groups was quite small. A longer follow-up period would be required to assess the long-term safety and effectiveness.
What’s next?
Consult your physician regarding the risks and benefits of leflunomide and tocilizumab combination therapy.
Published By :
PLOS ONE
Date :
Apr 01, 2015
