Effectiveness and safety of methotrexate versus leflunomide in 12-month treatment for Takayasu arteritis
| Autor: | Ying Sun, Yan Yan, Yun Liu, Rongyi Chen, Chunling Wu, Lili Ma, Xiaomeng Cui, Pingting Yang, Sifan Wu, Peng Lv, Zongfei Ji, Jiang Lin, Lindi Jiang, Huiyong Chen |
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| Rok vydání: | 2020 |
| Předmět: |
030203 arthritis & rheumatology
medicine.medical_specialty Treatment response business.industry lcsh:RM1-950 Takayasu arteritis Medicine (miscellaneous) 030204 cardiovascular system & hematology Gastroenterology 03 medical and health sciences lcsh:Therapeutics. Pharmacology 0302 clinical medicine Internal medicine medicine Methotrexate business Leflunomide medicine.drug Cohort study |
| Zdroj: | Therapeutic Advances in Chronic Disease, Vol 11 (2020) |
| ISSN: | 2040-6231 2040-6223 |
| Popis: | Aims: The study investigates the effectiveness and safety of methotrexate (MTX) versus leflunomide (LEF) in 12-month treatment of Takayasu arteritis (TAK). Methods: This was a cohort study. Patients diagnosed with TAK between 1 January 2013 and 1 January 2019 were enrolled from First Hospital of China Medical University and Zhongshan Hospital of Fudan University. Patients had active disease and were treated with glucocorticoid combined with LEF or MTX. Treatment response, imaging assessment and side-effects were evaluated during 12-month follow-up. Results: In total, 68 patients were enrolled (40 cases treated with LEF and 28 treated with MTX). At baseline, age, sex, disease duration and disease activity index showed no significant differences between groups. Prevalence of complete remission (CR) at 6 months was significantly higher in the LEF group than that in the MTX group (LEF versus MTX: 72.50% versus 53.57%, p = 0.04), though the CR prevalence at 9 months and 12 months showed no significant differences between groups. At 9 months, the prevalence of treatment resistance was much lower in the LEF group compared with MTX group (5.41% versus 11.54%, p = 0.03). Furthermore, prevalence of disease relapse in the LEF group was lower than that in MTX group at 12 months (7.24% versus 16.67%, p = 0.03). Patients with high baseline C-reactive protein levels (⩾15 mg/L) carried a higher risk of treatment resistance (OR = 1.36, 95% CI 1.07–13.41, p = 0.06) and disease relapse (HR = 2.51, 95% CI 1.36–12.98, p = 0.04). Conclusion: LEF might provide a quicker treatment response with lower prevalence of disease relapse compared with that elicited in MTX during 12 months follow-up for TAK. |
| Databáze: | OpenAIRE |
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