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Cochrane Database of Systematic Reviews

Leflunomide for the treatment of rheumatoid arthritis

Overview of attention for article published in Cochrane database of systematic reviews, July 2002
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (61st percentile)

Mentioned by

1 Wikipedia page


126 Dimensions

Readers on

130 Mendeley
Leflunomide for the treatment of rheumatoid arthritis
Published in
Cochrane database of systematic reviews, July 2002
DOI 10.1002/14651858.cd002047
Pubmed ID

Manathip Osiri, Beverley Shea, Vivian Welch, Maria E Suarez-Almazor, Vibeke Strand, Peter Tugwell, George A Wells


Rheumatoid arthritis (RA) is a chronic inflammatory joint disease. Leflunomide, as an inhibitor of pyrimidine synthesis, has a different mechanism of action than other existing disease modifying anti-rheumatic drugs (DMARD). To determine the efficacy and toxicity of leflunomide compared to placebo or other DMARDs in the treatment of RA. We conducted a search in MEDLINE, EMBASE, Current Contents and the Cochrane Controlled Trial Register for trials up to December 2001. We also hand-searched reference lists and consulted content experts. Two independent reviewers selected the trials that met predetermined inclusion criteria. Two independent reviewers extracted data and assessed methodologic quality using standardized forms. Six trials were included in this review. Using the ACR20 improvement criteria, there was an absolute difference in improvement of 28% (95% confidence interval: 21 - 35%) favouring leflunomide (232 out of 413 leflunomide treated patients compared to 89 out of 311 placebo patients met the criteria). There was no difference in ACR20 response rate between the patients treated with leflunomide and SSZ or MTX at 6 and 12 months. Other clinical outcomes were improved significantly in the leflunomide group compared to placebo but not different from SSZ or MTX. Withdrawals due to adverse events with leflunomide were 10% greater than placebo (70 out of 416 compared to 18 out of 311 respectively). Important adverse events included gastrointestinal symptoms, elevated liver function tests, alopecia, and infections. Overall adverse events and withdrawals in the leflunomide group were not significantly different from SSZ or MTX. Leflunomide appears to improve all clinical outcomes and delay radiologic progression at both 6 and 12 months of treatment compared to placebo. Its efficacy and adverse events at 2 years of treatment are comparable to SSZ and MTX. Long-term efficacy and toxicity remains to be established.

Mendeley readers

The data shown below were compiled from readership statistics for 130 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Colombia 1 <1%
Brazil 1 <1%
Canada 1 <1%
Sri Lanka 1 <1%
Russia 1 <1%
Unknown 125 96%

Demographic breakdown

Readers by professional status Count As %
Researcher 20 15%
Student > Master 19 15%
Student > Ph. D. Student 17 13%
Student > Bachelor 12 9%
Student > Postgraduate 12 9%
Other 23 18%
Unknown 27 21%
Readers by discipline Count As %
Medicine and Dentistry 56 43%
Nursing and Health Professions 17 13%
Pharmacology, Toxicology and Pharmaceutical Science 7 5%
Psychology 3 2%
Social Sciences 3 2%
Other 9 7%
Unknown 35 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 July 2018.
All research outputs
of 13,210,683 outputs
Outputs from Cochrane database of systematic reviews
of 10,528 outputs
Outputs of similar age
of 262,291 outputs
Outputs of similar age from Cochrane database of systematic reviews
of 262 outputs
Altmetric has tracked 13,210,683 research outputs across all sources so far. This one is in the 49th percentile – i.e., 49% of other outputs scored the same or lower than it.
So far Altmetric has tracked 10,528 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.7. This one is in the 27th percentile – i.e., 27% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 262,291 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 61% of its contemporaries.
We're also able to compare this research output to 262 others from the same source and published within six weeks on either side of this one. This one is in the 23rd percentile – i.e., 23% of its contemporaries scored the same or lower than it.