Efficacy and safety of leflunomide in the treatment of plaque type psoriasis

Background Psoriasis is universal in occurrence, representing a lifelong burden for affected patients. Various modalities of treatment are available and new drugs are coming up but toxicity and cost of the drug is very important. Leflunomide is an immunomodulatory and anti- inflammatory drug effective in chronic plaque type Psoriasis. Objectives To assess the efficacy and safety of leflunomide in the treatment of chronic plaque type psoriasis. Patients and methods The prospective controlled randomized study was carried out in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2005 to June 2006 over a period of one and half years. Forty patients with moderate to severe plaque-type psoriasis patients were treated in two groups (A B). In group A, 20 patients were treated with leflunomide 100mg daily for 3 days, then 20mg daily for 12 weeks and in group B 7.5mg methotrexate was given in 3 divided doses 12 hourly for 12 weeks. The effectiveness and side effects were assessed at 4th week and 12th week of the study on the basis of psoriasis area and severity index (PASI). Result At the final follow up mean percentage of improvement of psoriasis was observed based on PASI score reduction. It was 52.14% in group A and 42.11% in group B. Conclusion From the current study it may be suggested that leflunomide is effective and well tolerated agent and has some advantages over methotrexate in the treatment of psoriasis