ABSTRACT
Objective: To evaluate the effect of leflunomide on laboratory parameters in patients of rheumatoid arthritis
Materials and Methods: A 24-week, single-blind study was carried out on 158 consecutive patients, aged 29-70 years, diagnosed with rheumatoid arthritis. They received tablet leflunomide 20 mg daily, orally. Laboratory tests were recorded at the initial visit and follow-ups. Leflunomide has been known to bring about changes in various blood parameters like hemoglobin, total white cell and platelet counts, erythrocyte sedimentation rate, serum creatinine and serum glutamic pyruvic transaminase levels. All patients were subjected to these laboratory tests
Results: At the end of the study at 24 weeks the hemoglobin was raised to 12.62 grams per deciliter [g/dl] from a baseline of 10.81 g/dl, white cell count fell to 6,728 per cubic mm [cmm] from 8,318 / cmm, the ESR fell to 39.01 millimeters of mercury [mm of Hg] in 1st hour from 82.10 mm of Hg, the platelet count fell to 2,37,419 / cmm from 2, 96,166 / cmm, the SGPT levels were raised to 38.01 international units per litre [IU/l] from 31.84 IU/l and the serum creatinine fell to 0.936 mg/dl from 0.937 mg/dl. All values, except serum creatinine, were found to be highly significant statistically [p<0.001]
Conclusion: Leflunomide showed significant effects on the laboratory parameters. These parameters may be utilized in patients follow up to monitor the drug response and as a marker of drug safety of leflunomide
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Aspergillosis/complications , Nasal Polyps/microbiology , Rhinitis, Allergic/complications , Sinusitis/complications , Sphenoid Bone/microbiology , Chronic Disease , Rhinitis, Allergic/microbiology , Sinusitis/microbiology , Sphenoid Bone/pathology , Tomography, X-Ray ComputedABSTRACT
One out of five Saudi diabetics develops end-stage renal disease [ESRD]. Factors associated with progressive loss of renal function have not been extensively studied and reported in our community. We sought to evaluate the pattern and progression in glomerular filtration rate [GFR] and investigate the potential risk factors associated with progression to diabetic nephropathy [DN] among Saudi patients. Hospital-based retrospective analysis of type 2 diabetic patients seen between January 1989 and January 2004 at Security Forces Hospital and King Saud University in Riyadh, Saudi Arabia. DN was defined as persistent proteinuria assessed by urine dipstick [at least twice for at least two consecutive years and/or serum creatinine >130 micromol/L; and/or GFR <60 mL/min/1.73m[2]. Of 1952 files reviewed, 621 [31.8%] met the criteria for DN, and 294 [47%] were males. The mean [SD] age of the patients at baseline was 66.9 [11.4] years, and mean duration of diabetes was 15.4 [7.5] years. GFR deteriorated from a baseline value of 78.3 [30.3] mL/min/1.73m[2] to 45.1 [24.1] mL/min/1.73m[2] at the last visit, with a mean rate of decline in GFR of 3.3 mL/min/year. Progression of nephropathy was observed in 455 [73.3%] patients, with 250 [40.3%] patients doubling their first-hospital-visit serum creatinine level in a mean of 10.0 [6.0] years. At the end of the study, 1 6.5% of the cohort developed ESRD and were dialyzed. GFR >90 mL/min/1.73m[2] at the first hospital visit; duration of diabetes >10 years; persistent proteinuria; systolic blood pressure >130 mm Hg; and presence of retinopathy were significant markers associated with progression of nephropathy. Diabetic nephropathy tends to be progressive among Saudis, with GFR deteriorating at a rate of 3.3 mL/year and with a doubling of serum creatinine level in 40.3% of patients in 9.9 years