Abstract
Patients and methods: Twenty patients with AS fulfilling the 1984 modified New York criteria with a Bath AS Disease Activity Index (BASDAI) >3 were given leflunomide for 6 months. Clinical outcome assessments included disease activity (BASDAI), function (BASFI), metrology (BASMI), patient's and physician's global assessment, peripheral joint assessment, quality of life (SF-36), global pain, and CRP. Primary end point was a reduction of disease activity as measured by the BASDAI of >25% at 6 months.
Results: A BASDAI 25% improvement was noted in 5/20 (25%) patients and a BASDAI 50% improvement in 4/20 (20%) patients. The absolute BASDAI did not change significantly over the 6 month study (4.9 at baseline v 4.3 at week 24, p>0.05). Similarly, no significant change was found for the BASFI, BASMI, patient's and physician's global assessment, SF-36 mental component, and CRP. For the 10 patients with peripheral arthritis, the mean number of inflamed joints was significantly reduced from 1.7 at baseline to 0.9 at week 12 (p = 0.034) and 0.2 at week 24 (p = 0.039).
Conclusion: In this open study of patients with active AS only those with peripheral arthritis improved significantly with leflunomide treatment. Axial symptoms did not improve.
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Figure 1.
Response to treatment with leflunomide in 20 patients with AS. (A) BASDAI before, during, and after treatment with leflunomide over 24 weeks in all patients with AS, in 10 patients with AS without peripheral arthritis and 10 with peripheral arthritis. *p>0.05 versus baseline. (B) Number of swollen joints before, during, and after treatment with leflunomide over 24 weeks. **p = 0.036 week 12 v baseline; ***p = 0.016 week 24 v baseline.