Leflunomide (ARAVA®) is a newer disease modifying drug for the treatment of rheumatoid arthritis. Inhibition of pyrimidine synthesis with consequent modification of activated T-cell function is postulated to be a mechanism of the drug effect. Leflunomide significantly decreases clinical activity of RA, even in the long-term; favorably influences functional status and slows x-ray progression of RA patients. The authors discuss here the results of postmarketing, open study performed in the Czech Republic that comprised 999 patients. Mean duration of the treatment was 10.5 ± 5.8 months (0-41). Beneficial therapeutical response was achieved in 68.3 % patients after 6 months (decrease of DAS28 > 1.2). Significant reduction of swollen and tender joints as well as CRP (p < 0.001) was also observed. The treatment was well tolerated, serious adverse events (without permanent consequences) occurred within 2 % of patients. Serious hepatotoxicity was not detected. Seventy-nine patients still remain on leflunomide after 10 months of treatment. Number of patients who returned to work increased from 22 % to 39 %. Good risk/benefit ratio of leflunomide and probably also good pharmacoeconomic parameters of the treatment are demonstrated in this study.

        Key words: rheumatoid arthritis, leflunomide, DMARDs