@article{fecf502d1a654afeb20e9f1e0e685990,
title = "Efficacy of leflunomide in the treatment of vasculitis",
abstract = "Objective. Only a few small case series, case reports, and one small clinical trial suggested some benefit of leflunomide (LEF) in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis and other vasculitides. We analysed the clinical efficacy and tolerability of LEF in a large cohort of patients with various vasculitides. Methods. This was a retrospective analysis of patients who received LEF for treatment of their vasculitis enrolled in the Vasculitis Clinical Research Consortium (VCRC) Longitudinal Study and in 3 additional centres from the Canadian vasculitis research network (CanVasc). Results. Data for 93 patients were analysed: 45 had granulomatosis with polyangiitis (GPA), 8 microscopic polyangiitis (MPA), 12 eosinophilic granulomatosis with polyangiitis (EGPA), 14 giant-cell arteritis (GCA), 9 Takayasu{\textquoteright}s arteritis (TAK), and 5 polyarteritis nodosa (PAN). The main reason for initiation of LEF was active disease (89%). LEF was efficacious for remission induction or maintenance at 6 months for 62 (67%) patients (64% with GCA, 89% with TAK, 80% with PAN, 69% with GPA, 75% with MPA, 33% with EGPA); 20% discontinued LEF before achieving remission because of persistent disease activity. Overall, 22 adverse events (gastrointestinal symptoms being the most common) led to drug discontinuation in 18 (19%) patients, of which 12 stopped LEF before month 6, before showing any benefit in 8/12 of these patients. Conclusion. Leflunomide can be an effective therapeutic option for various vasculitides, especially for non-severe refractory or relapsing ANCA-associated vasculitis or large-vessel vasculitis. No new safety signals for LEF were identified in this population.",
keywords = "ANCA, Efficacy, Leflunomide, Safety, Vasculitis",
author = "{the Canadian Vasculitis Research Network (CanVasc)} and {Vasculitis Clinical Research Consortium (VCRC)} and N. Mustapha and L. Barra and S. Carette and D. Cuthbertson and Khalidi, {N. A.} and Koening, {C. L.} and Langford, {C. A.} and McAlear, {C. A.} and N. Milman and Moreland, {L. W.} and Monach, {P. A.} and P. Seo and U. Specks and Sreih, {A. G.} and Ytterberg, {S. Y.} and Merkel, {P. A.} and C. Pagnoux",
note = "Funding Information: N. Khalidi reports personal fees and non-financial support from Roche, nonfinancial support from Bristol Myers Squibb outside the present work. A.G. Sreih is an employee of Bristol Myers Squibb. P.A. Merkel reports receiving funds for the following activities in the past 2 years: Consulting: AbbVie, Astra-Zeneca, Biogen, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, Chemo-Centryx, CSL Behring, Forbius, Genen-tech/Roche, Genzyme/Sanofi, GlaxoS-mithKline, InflaRx, Insmed, Jannsen, Kiniksa, Kyverna, Magenta, Novartis, Pfizer, Sparrow, Takeda, Talaris; Research Support: AstraZeneca, Boering-her-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx; Royalties: UpToDate. C. Pagnoux reports receiving fees for serving on advisory boards from Chemocentryx, Glaxo-SmithKline, Sa-nofi, and Hoffman-LaRoche; he also reports lecture fees and research grant support from Hoffman-La Roche. The other co-authors have declared no competing interests. Funding Information: N. Mustapha was funded by a vasculitis fellowship granted by the Vasculitis Program (University of Toronto) and the Royal College of Physicians of Canada. The Vasculitis Clinical Research Consortium (VCRC) is part of the Rare Diseases Clinical Research Network (RDCRN), an initiative of the Office of Rare Diseases Research (ORDR), National Center for Advancing Translational Science (NCATS). The VCRC is funded through collaboration between NCATS and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), U54 AR057319) and has received funding from the National Center for Research Resources (U54 RR019497). Funding Information: Funding: N. Mustapha was funded by a vasculitis fellowship granted by the Vasculitis Program (University of Toronto) and the Royal College of Physicians of Canada. The Vasculitis Clinical Research Consortium (VCRC) is part of the Rare Diseases Clinical Research Network (RDCRN), an initiative of the Office of Rare Diseases Research (ORDR), National Center for Advancing Translational Science (NCATS). The VCRC is funded through collaboration between NCATS and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), U54 AR057319) and has received funding from the National Center for Research Resources (U54 RR019497). Competing interests: page S117. Publisher Copyright: {\textcopyright} Copyright CliniCal and ExpErimEntal rhEumatology 2021.",
year = "2021",
language = "English (US)",
volume = "39",
pages = "S114--S118",
journal = "Clinical and Experimental Rheumatology",
issn = "0392-856X",
publisher = "Clinical and Experimental Rheumatology S.A.S.",
number = "2",
}