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Rheumatol Int. 2006 Oct;26(12):1138-42. Epub 2006 May 31.

Leflunomide increases the risk of early healing complications in patients with rheumatoid arthritis undergoing elective orthopedic surgery.

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  • 1Department of Orthopedics, Rheumaklinik Bad Bramstedt, Oskar-Alexander-Str. 26, 24576 Bad Bramstedt, Germany.


The aim of this object is to study whether treatment with biological or leflunomide increases the risk of wound-healing complications after elective orthopedic surgery. Between March 2002 and September 2003, 201 patients participated in this study with the following inclusion criteria: (a) Rheumatoid arthritis (RA) or psoriatic arthritis (psA), (b) therapy with: MTX, leflunomide, etanercept, infliximab, adalimumab, anakinra, (c) undergoing elective orthopedic surgery. The incidence of early postoperative wound-healing complications was compared among the different groups. In comparison with patients who received MTX therapy (n = 59), the risk of postoperative wound-healing complications in patients undergoing leflunomide therapy (n = 32) was significantly higher: 13.6% in the MTX group, 40.6% in the leflunomide group (P = 0.01). It is recommended that leflunomide medication for patients with RA undergoing elective orthopedic surgical procedure is interrupted preoperatively to reduce the risk of early wound-healing complications or infections.

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