Exploring Leflunomide’s Role in RA with Interstitial Lung Disease

In Sum

Leflunomide is rarely the first DMARD used for treatment of RA and is, in fact, most often used after methotrexate has been discontinued for various reasons, or less often in combination with methotrexate, if methotrexate monotherapy is not adequate to control disease activity. Therefore, it may never be possible to determine the exact incidence of lung toxicity directly caused by leflunomide.

However, the newer data should help alleviate concerns of rheumatologists considering leflunomide as a viable conventional DMARD alternative to methotrexate in patients with ILD, before moving on to other more expensive biologic drugs. 

Rajandeep Paik, MD, FACR, is a rheuma­tologist practicing in Malden, Mass. He works for Cambridge Health Alliance and is a lecturer in medicine at Harvard Medical School, Boston. Dr. Paik is board certified in rheumatology and internal medicine, and an ACR fellow.

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