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Leflunomide Treatment in Elderly Patients

What is Leflunomide?

The National Rheumatoid Arthritis Society tells us that “Leflunomide is a disease modifying anti-rheumatic drug (DMARD) developed specifically to control inflammatory arthritis.” It is one of a number of DMARD drugs used to combat the symptoms of rheumatoid arthritis and is usually marketed under the name Arava.

Leflunomide is a ‘disease-modifying’ drug and is one of a number of different treatments that may be used to relieve the symptoms of rheumatoid arthritis. Others includes methotrexate, hydroxychloroquine, and sulfasalazine. Every person being treated for rheumatoid arthritis is an individual and their immune system may respond differently to different medications, so your healthcare professional will need to prescribe different medications until the one that suits you best is found.

DMARDS are different to traditional anti-inflammatories because they can take several weeks to start to be effective and then continue to improve, until after about six months they will be working at their full effectiveness. This does however mean that if you are being tried on different DMARDS it may take some time to find the best one for you, as each will have to go through the same trial and error process. As with any medication there are some side-effects that are more common than others, and with Leflunomide these can include:

  • Increased blood pressure
  • Diarrhoea
  • Higher susceptibility to infections
  • Shortness of breath and/or cough
  • A numbness or tingling in the hands and/or feet

However, your healthcare team will work with you to find treatments and drugs that work for you, meaning you live your best quality of life, and your condition will be kept under control as much as possible.

What Ailments is Leflunomide Used to Treat?

The NRAS tell us that “Leflunomide was developed specifically to control inflammatory arthritis.” It is now a common treatment for rheumatoid arthritis and has been in use since the early 2000s. Rheumatoid Arthritis causes pain, swelling and stiffness in the joints and is a long-term condition. Usually, the condition affects the feet, hands, and wrists but some people also experience symptoms in other parts of the body. The condition can also cause tiredness and weight loss, amongst other consequences. The condition will ‘flare up’ at times and become more pronounced, but these flare-ups can be difficult for medical practitioners to predict. They will be kept as controlled as possible through treatments and medication such as Leflunomide, with a focus on reducing long-term damage to the joints. Your healthcare team will also ensure that any other medication that you’re taking doesn’t adversely affect the Leflunomide, especially if you’re taking Warfarin and other similar prescription drugs.

How Does Leflunomide Work?

According to the NHS, “DMARDs work by blocking the effects of the chemicals released when your immune system attacks your joints, which could otherwise cause further damage to nearby bones, tendons, ligaments and cartilage.” Leflunomide may be prescribed along with another DMARDs in the first instance, such as Methotrexate, along with “a short course of steroids (corticosteroids) to relieve any pain.” The immune system is overactive in someone living with Rheumatoid Arthritis, attacking parts of the musculoskeletal system, which is why medication that reduces the immune system’s ability to make these attacks, and that reduces the effect of these attacks on the body, are necessary.

According to the NRAS, “Leflunomide acts on an enzyme in the body to limit the excessive reaction of the cells involved during inflammation, thereby reducing the swelling, pain and problems of RA.” Leflunomide, and other DMARDs, work slowly and will need to be given time to have an effect. It will be prescribed by a specialist who has experience working with rheumatoid arthritis and blood tests will need to be taken before commencement of any DMARD to check for suitability, and “usually every two weeks during the first six months of treatment and every eight weeks afterwards.” Leflunomide usually begins as a 10mg or 20mg tablet every day, depending on the specialist’s judgement and suitability for the patient.

Leflunomide is not a ‘quick fix’ medication as it, and other DMARDs, act slowly. They work over weeks and months, helping to reduce the “pain, swelling, heat and redness” caused by the overactive immune system attacking the joints and other areas. Leflunomide ‘switches off’ the cells responsible for the overactivity, helping to reduce symptoms.

Around 1% of the population, or 400,000 people, are living with rheumatoid arthritis. Usually diagnosed between the ages of 40 and 50 years, the condition is most common amongst women, and RA symptoms are often worse in the morning or after a period of inactivity. Gentle exercise can help with flare-ups of symptoms, and your medical professional will be able to advise you on what best to do. Putting heated or cold items on the joint may also help to relieve symptoms and communicating what works best for you can ensure those around you are able to help as much as possible.

If you’re living with Rheumatoid Arthritis and are struggling to manage, support at home from Helping Hands may be the answer to your everyday difficulties. Our amazing carers can undertake any aspect of your daily routine, such as housework, laundry, accessing the community, and helping you to manage your medication. They can also help you with your personal care, cook nutritious meals, accompany you to medical appointments and so much more. Our carers across England and Wales can visit you as often as you need us and even offer live-in care, meaning that regardless of the severity of your condition, you’ll be able to live as comfortably as possible in the home you love. We support people aged 18+ to live their very best life possible, and once your RA is under control with medication and therapies there’s no reason you shouldn’t do the same. So whether you are living alone, with a partner, or have kids still in the house, we can support you as often as you need us to help you carry on as you’ve always done.