Tratamentul cu leflunomide versus tratamentul cu azatioprina în controlul formelor severe de poliartrită

Abstract

Aggressive treatment with immunosuppressive agents is recommended for severe rheumatoid arthritis in order to improve the short and long term prognosis, thus adding additional treatment related toxicity. The present study compares a classic immunosuppressive agent, azathioprinum with a more selective immunomodulating agent, leflunomidum in 31 patients with severe rheumatoid arthritis. 18 patients received leflunomide and 13 patients azathioprinum. After nine months, compared to azathioprinum, leflunomide significantly reduced the DAS 28 score (88.88% vs. 38.46%, p<0.01), serum titres of antiCCP antibodies (72.22% vs.7.69%, p<0.001), serum concentration of beta2 microglobulin (83.33% vs.30.76%) and the systemic steroid load necessary to control disease flares (929 mg methiprednisolone/month vs. 1770 methiprednisolone/month, p<0.001). Both treatment were equally efficient in reducing rheumatoid factor titres and serum concentration of CRP.