| Title |
Leflunomide for the treatment of rheumatoid arthritis
|
|---|---|
| Published in |
Cochrane database of systematic reviews, July 2002
|
| DOI | 10.1002/14651858.cd002047 |
| Pubmed ID | |
| Authors |
Manathip Osiri, Beverley Shea, Vivian Welch, Maria E Suarez‐Almazor, Vibeke Strand, Peter Tugwell, George A Wells |
| Abstract |
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 175 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 | 170 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 23 | 13% |
| Researcher | 22 | 13% |
| Student > Ph. D. Student | 19 | 11% |
| Student > Bachelor | 16 | 9% |
| Student > Doctoral Student | 12 | 7% |
| Other | 32 | 18% |
| Unknown | 51 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 69 | 39% |
| Nursing and Health Professions | 17 | 10% |
| Pharmacology, Toxicology and Pharmaceutical Science | 9 | 5% |
| Biochemistry, Genetics and Molecular Biology | 4 | 2% |
| Psychology | 4 | 2% |
| Other | 13 | 7% |
| Unknown | 59 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 6. 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 06 June 2023.
All research outputs
#5,471,255
of 25,457,858 outputs
Outputs from Cochrane database of systematic reviews
#7,375
of 11,499 outputs
Outputs of similar age
#8,297
of 47,731 outputs
Outputs of similar age from Cochrane database of systematic reviews
#10
of 35 outputs
Altmetric has tracked 25,457,858 research outputs across all sources so far. Compared to these this one has done well and is in the 75th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,499 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 40.0. This one is in the 34th percentile – i.e., 34% 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 47,731 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 71% of its contemporaries.
We're also able to compare this research output to 35 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 65% of its contemporaries.