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Efficacy and safety of leflunomide in psoriatic arthritis treatment: A single‐arm meta‐analysis
Aim To systematically assess the clinical efficacy and safety of leflunomide for treating psoriatic arthritis (PsA). Methods PubMed, Embase, and Cochrane Library databases were searched until 1 January, 2018, to include relevant studies in this single‐arm meta‐analysis. Psoriasis improvement was eva...
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Published in: | International journal of rheumatic diseases 2019-08, Vol.22 (8), p.1498-1505 |
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Main Authors: | , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Aim
To systematically assess the clinical efficacy and safety of leflunomide for treating psoriatic arthritis (PsA).
Methods
PubMed, Embase, and Cochrane Library databases were searched until 1 January, 2018, to include relevant studies in this single‐arm meta‐analysis. Psoriasis improvement was evaluated using Psoriasis Area and Severity Index (PASI) scores. The primary outcome in patients was assessed using the Psoriatic Arthritis Response Criteria (PsARC). Other effectiveness evaluations included those of adverse events, quality of life including functional status (Health Assessment Questionnaire [HAQ] total score), and a quality‐of‐life instrument for dermatologic diseases (Dermatology Life Quality Index [DLQI] total score).
Results
A total of 6 studies were included. After leflunomide treatment, 48% of the patients experienced a reduction of ≥50% based on PASI scores (95% confidence interval [CI]: 0.22‐0.73). PASI 75 improvement was observed among 25% of the patients (95% CI: 0.11‐0.38). The primary effectiveness analysis revealed that 15% of the patients (95% CI: 0.07‐0.26) discontinued leflunomide treatment. Further, 77% of the patients (95% CI: 0.59‐0.92) achieved a PsARC response. Adverse events occurred in 38% of the patients (95% CI: 0.04‐0.71). The mean ± SD percentage PASI improvement was −4.88 (95% CI: −8.92, −0.85). Moreover, DLQI and HAQ were −2.02 (95% CI: −3.01, −1.03) and −0.19 (95% CI: −0.29, −0.09), respectively.
Conclusions
Leflunomide is an effective and well‐tolerated treatment for PsA, and would be a safe and convenient option. |
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ISSN: | 1756-1841 1756-185X |
DOI: | 10.1111/1756-185X.13599 |