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Sarcoidosis Vasc Diffuse Lung Dis. 2013 Nov 22;30(3):167-76.

Leflunomide-induced interstitial lung disease (a systematic review).

Author information

1
Northwestern University Feinberg School of Medicine, Chicago, IL. rishi.raj@northwestern.edu.

Abstract

BACKGROUND:

Leflunomide, a disease modifying anti-rheumatic drug in use since 1998, causes interstitial lung disease (ILD) and other pulmonary complications.

METHODS:

We undertook a systematic review of literature of PubMed (March 2013) to identify the published literature pertaining to pulmonary toxicity associated with leflunomide.

RESULTS:

We identified 41 relevant articles detailing four population studies and case reports/series on an additional 42 patients. Available data were reviewed and summarized.

CONCLUSIONS:

Leflunomide can cause ILD. Most of these patients present within three months of starting leflunomide with acute symptoms for a week or less. Bilateral ground glass opacities and diffuse alveolar damage are the most common radiologic and histopathologic findings, respectively. Patients with pre-existing ILD are particularly at risk for this complication, and leflunomide should be avoided in this population. Activated charcoal and cholestyramine significantly decrease the half-life of the drug because of its enterohepatic circulation and should be considered in cases with acute toxicity.

PMID:
24284289
[Indexed for MEDLINE]

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