Vol.23 No.4

Original Article

Risk factors of severe infections in patients with rheumatoid arthritis treated with leflunomide

Authors

Han-Gyul Yoo1 , Hea Min Yu2 , Jeon Byung Jun2 , Hyun-Soon Jeon2 , Wan-Hee Yoo2

  • Department of Pharmacy Practice, University of Rhode Island, Kingston, RI 02881, USA
  • Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine of Chonbuk National University Hospital, Chonbuk National University, San 2-20 Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk, 561-712, South Korea
Received:

14 March 2012

Accepted:

25 June 2012

Published online:

13 July 2012

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Abstract

Objectives To determine the risk of severe infection requiring or complicating hospitalization associated with leflunomide therapy in patients with rheumatoid arthritis (RA).
Methods We performed a retrospective study of RA patients who were prescribed leflunomide between 2004 and 2011. Background clinical and laboratory features were compared between patients who suffered severe leflunomide-associated infections and those who did not.
Results Since January 2005, 401 RA patients have started on leflunomide. Among those, 33 (8.2 %) developed severe infections: pneumonia, oral candidiasis, pyelonephritis, pulmonary tuberculosis, cellulitis, disseminated herpes zoster, tonsillitis, and pulmonary cryptococcosis. Logistic regression showed that age at entry, the presence of DM, and daily dosage of corticosteroid were associated with development of severe infections.
Conclusions These results showed that some patients with RA who were taking leflunomide developed severe infections requiring hospitalization, and that older age, DM, and a higher daily dosage of corticosteroid were risk factors associated with leflunomide-associated severe infections.

Key words

Infection, Leflunomide, Rheumatoid arthritis