The effect of leflunomide on cold and vibratory sensation in patients with rheumatoid arthritis

Abstract

Objective To evaluate the prevalence and risk factors of peripheral neuropathy in patients with rheumatoid arthritis (RA) treated with lefl unomide (LEF) by quantitative sensory testing (QST). Method A total of 94 patients were enrolledin this study, out of which 47 patients received LEF. The other 47patients received alternative disease-modifying antirheumatic drugs and served as the control group. The demographic characteristics, laboratory fi ndings, concomitant diseases, and medication history were evaluated at the time of QST. Th e cooling (CDT) and vibratory detection threshold (VDT) as the representative components of QST were measured. Results Age, gender, RA duration, ESR, and CRP did not show any signifi cant diff erences between the two groups. VDT did not demonstrate any signifi cant diff erence in both groups. However, CDT in LEF group was signifi cantly higher than that of the control group (8.6±2.7 in LEF vs. 5.6±3.8 in control). The proportion of RA patients in the LEF group showing abnormally high CDT was over 2 times greater than that of the control group, but these fi ndings were not statistically signifi cant. Age, RA duration (or LEF medication in LEF group), ESR, and CRP did not show signifi cant correlation with CDT in both groups. VDT signifi cantly correlated with age in both groups. Conclusion LEF treatment in patients with RA may lead to abnormal CDT in QST. CDT value was not aff ected by age, RA duration, disease activity, or LEF duration. It remains to be determined whether QST may be a valuable non-invasive instrument to evaluate the early sensory changes in patients with RA taking LEF.