RT Journal Article
SR Electronic
T1 Effectiveness and safety of leflunomide for pulmonary and extrapulmonary sarcoidosis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1145
OP 1150
DO 10.1183/09031936.00195010
VO 38
IS 5
A1 D.H. Sahoo
A1 D. Bandyopadhyay
A1 M. Xu
A1 K. Pearson
A1 J.G. Parambil
A1 C.A. Lazar
A1 J.T. Chapman
A1 D.A. Culver
YR 2011
UL http://erj.ersjournals.com/content/38/5/1145.abstract
AB Leflunomide has been reported as an alternative therapy in sarcoidosis. However, the published data are limited. We performed a retrospective chart review of the tolerance and effects of leflunomide therapy in patients with sarcoidosis. 76 patients were included. The most common reasons for initiation were progression of disease or failure of other immunomodulator therapy. Side-effects attributable to leflunomide were noted in 34% of subjects, prompting discontinuation in 17%. The lungs were a target of therapy in 33 (44%) and extrapulmonary organs were a target in 45 (59%). The mean±sd change in forced vital capacity in the 6 months prior to leflunomide was −0.1±0.3 L, and it was +0.09±0.3 L in the following 6 months (p=0.01). For extrapulmonary target organ response, 51% had a good response and 32% a partial response. The median corticosteroid dose at initiation was 10 mg (interquartile range 5–20) mg at baseline, and 0 (0–10) mg at the 6-month follow-up (p<0.001). Leflunomide is a viable alternative agent for pulmonary and extrapulmonary sarcoidosis. Leflunomide appears to facilitate reduction of steroid dose and can be considered as monotherapy or as add-on therapy in cases of progressive disease.