Individualization of leflunomide dosing in rheumatoid arthritis patients

Ashley M Hopkins, Catherine E O'Doherty, David JR Foster, Richard N Upton, Susanna M Proudman, Michael D Wiese

Research output: Contribution to journalReview articlepeer-review

7 Citations (Scopus)


Leflunomide is largely considered to be a second-line treatment option for rheumatoid arthritis (RA). Those who fail to respond, tend to progress to treatment with expensive biological agents, which can also be associated with serious toxicities. Optimizing leflunomide treatment to meet the needs of individuals would hence be beneficial in terms of patient outcomes and health care expenditure. In this respect, therapeutic drug monitoring (TDM) may be useful, as plasma concentrations of leflunomide's active metabolite, teriflunomide, correlate with response to treatment, but are highly variable between patients. A number of pharmacogenetic markers have also been identified that influence response and toxicity. Incorporation of these findings into clinical practice could facilitate more efficient use of leflunomide.

Original languageEnglish
Pages (from-to)449-461
Number of pages13
JournalPersonalized Medicine
Issue number4
Publication statusPublished - Jun 2014
Externally publishedYes


  • leflunomide
  • pharmacogenomics
  • rheumatoid arthritis
  • teriflunomide
  • therapeutic drug monitoring


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