Leflunomide and methotrexate

Methotrexate and leflunomide are both effective drugs in the treatment of p atients with rheumatoid arthritis. Methotrexate has been available for many years, whereas leflunomide is a relatively new drug. Several large trials describing its efficacy and safety in comparison with both sulfasalazine an d methotrexate and with placebo have been published recently, It appears th at leflunomide is approximately equally effective as sulfasalazine and meth otrexate. New data are also available on the mechanism of action of lefluno mide especially. This drug probably acts as an immunomodulatory agent by in terfering with the de novo synthesis of pyrimidines. (C) 2001 Lippincott Wi lliams & Wilkins, Inc.