Lung Study Questions Arava Safety in RA | Arthritis Information

 

TOKYO, Japan—Rheumatologists who  use leflunomide (Arava^®, Sanofi Aventis) in rheumatoid arthritis (RA) patients should be on the look-out for early signs of lung disease in their patients, according to a new study and editorial in Rheumatology.^1,2

In the new study of 5,054 Japanese RA patients who took leflunomide over a 24 week period, 1.2% of patients developed and/or experienced an exacerbation of interstitial lung disease (ILD). The presence of ILD increased the odds of developing leflunomide lung disease by 8. Cigarette smoking increased the odds of developing or having an exacerbation of ILD by 3.12. Other risk factors for leflunomide-induced lung disease included a low body weight and the use of a loading dose, the study showed.

We suggest that leflunomide should not be prescribed for RA patients complicated with ILD,” conclude  the researchers who were led Tetsuji Sawada, MD, a rheumatologist at Tokyo Medical University Hospital in Japan.

http://www.mskreport.com/articles.cfm?articleID=3379This is scary!  I was unable to take Arava due to gastro issues.  With the lung complications I have, I guess it turned out to be a good thing. It is definately not a med for people with lung issues...

Arava data might not be generalizable to other RA populations, but rule out ILD

At least one US rheumatologist urges caution as the new findings may be dose-related and not generalizable to international populations. “The drug may have a bad reputation and that is unfortunate and not warranted because it is a good drug and helps treat joint manifestation, but it has the potential to cause lung disease as do other immunosuppressive arthritis drugs, and we have to keep eye out,” said Aryeh Fischer, MD, the co-director of the Autoimmune Lung Center at the National Jewish Health in Denver, Colorado.

In an accompanying editorial,² Clive Kelly, MD, a rheumatologist at Queen Elizabeth Hospital in Tyne and Wear, UK, suggests that “clinicians may be wise to undertake prior assessment of pulmonary function test in high-risk patients, especially those of Japanese or Korean origin.” Dr. Kelly also suggests that physicians rule out ILD with a high resolution CT scan of the chest before starting leflunomide therapy.

Lynn492009-07-03 15:36:58Thank fully I could not tolerate this drug because of very bad  gastro issues.............. I think chest x-rays are suggested prior to starting biologics as well as a baseline.  That is how they found my lung issues. tttJust wanted to say welcome to the newbie. LOL Now this is the kind of memeber we need more of. To the top welcome.thank you milly tothetopThis is one of those things you have to weigh out to figure the benefit I guess...  [QUOTE=Lynn49] Other risk factors for leflunomide-induced lung disease included a low body weight and the use of a loading dose, the study showed.[/QUOTE]
THIS is important information and should be emphasized. Recently there was a discussion re: loading doses and Arava. (My search skills seem to have pfffttt and I cannot find it to post this link therein...).

Thanks again Lynn for providing timely, pertinent, and important information for us: I know that I could do WWW searches, etc. to gain insights on AI and therapies but having your present them here saves me much effort and much energy.

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