A Meta-analysis Of Efficacy And Safty Of Leflunomide And Methotrexate In Treatment Of Patients With Rheumatiod Arthritis

Objective: To evaluate the efficacy and safety of Leflunomide (LEF) in thetreatment of Rheumatoid Arthritis (RA). Methods: Randomized controlled trials (RCTs)about the effect of LEF on patients with RA from January1989to January2011weresearched for according to inclusion and exclusion criteria. sixteen studies were chosen atlast for Meta-analysis. The data were analysed by REVMAN5.0software. Results: Themeta analysis showed: First, After therapy, there is no significant difference in the ACR20response rate was found between LEF and MTX (P＞0.05) Second, The clinical’sefficacy were assessed with the weighted mean difference (WMD) of Morning stiffiness,Resting pain, Swollen joint count, Swollen joint score, tender joint count, tender jointscore, erythrocyte sedimentation rate, rheumatoid factor, C-reactive protein.OverallWMD-0.26(P＜0.05) were for the morning stiffiness,-0.35(P＜0.05) for the restingpain,-0.60(P＜0.05) for the swollen joint count,-1.00(P＜0.05) for the Swollen jointscore,-0.81(P＜0.05) for the tender joint count,-1.53(P=0.05) for the tender joint score,-2.61(P＜0.05) for the erythrocyte sedimentation rate,-0.10(P＞0.05) for therheumatoid factor,-0.09(P＜0.05) for the C-reactive protein.finally the results ofmeta-analyses showed that compared with the control group about the incidence ofadverse response: Leflunomide was superior to Methotrexate(P＜0.05). Conclusion:Based on the current studies, Leflunomide is not inferior to the commonly usedMethotrexate in treatment of rheumatiod arthritis at present., but Leflunomide wassuperior to Methotrexate in the incidence of adverse reactions. For the quality restrictionsof the included studies, more double blind RCTs with high quality are required to furtherassess the effects.