Dynamic MRI Study Differentiates Leflunomide Versus Methotrexate for RA

NEW YORK (Reuters Health) Mar 12 – Dynamic gadolinium-enhanced magnetic resonance imaging (DEMRI) provides a sensitive measure of inflammatory changes in the synovium of patients with active rheumatoid arthritis (RA). When used to evaluate treatment response to leflunomide or methotrexate, DEMRI showed that leflunomide was more effective in reducing synovial inflammation of the knee.
In a prospective analysis, Dr. Paul Emery, of the University of Leeds School of Medicine in the UK, and associates treated 17 patients with leflunomide, initially at 100 mg/day for 3 days, then reduced to 20 mg/day. Another 17 patients were treated with methotrexate 7.5 mg/week, increased to 15 mg/week over 12 weeks.

After 4 months' treatment, clinical outcomes were similar between groups, the European investigators report in the February issue of Arthritis and Rheumatism. However, they observed a trend for greater improvement in tender joint count, morning stiffness duration, pain intensity, C reactive protein and rheumatoid factor titer in the leflunomide group.

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