Peer-reviewed veterinary case report
Long-term leflunomide with prednisone or NSAIDs is safe for dogs
By Chesne, Rebecca B et al.·Published in Journal of the American Veterinary Medical Association·2024·View original on PubMed →
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Original publication title: Leflunomide with prednisone or nonsteroidal anti-inflammatory drug therapy is safe and tolerated for long-term treatment of immune-mediated polyarthritis in 27 dogs.
- Species:
- dog
Plain-English summary
A group of 27 dogs with immune-mediated polyarthritis (a condition where the immune system attacks the joints) were treated with a medication called leflunomide, either alone or with prednisone or nonsteroidal anti-inflammatory drugs (NSAIDs). While some dogs experienced mild side effects like vomiting and diarrhea, most tolerated the treatment well. Notably, dogs receiving leflunomide with NSAIDs had fewer liver issues compared to those treated with leflunomide and prednisone. Overall, leflunomide proved to be a safe long-term option for managing this condition in dogs.
People also search for: dog immune-mediated polyarthritis treatment · leflunomide side effects in dogs · prednisone vs NSAID for dog arthritis
Abstract
OBJECTIVE: To retrospectively evaluate safety and tolerance of leflunomide for long-term treatment of canine idiopathic immune-mediated polyarthritis (IMPA). ANIMALS: 27 dogs with clinical signs and synovial fluid cytology supportive of IMPA with ≥ 6 months' follow-up after starting leflunomide. METHODS: Medical records were reviewed to identify dogs prescribed leflunomide for treatment of IMPA from February 2012 to May 2022. Initial leflunomide doses of 2 to 4 mg/kg once daily were prescribed and were titrated to the lowest effective dose with concurrent anti-inflammatory therapy. Complete blood count, serum chemistry, and clinical signs were monitored throughout the course of treatment. RESULTS: Adverse effects potentially attributable to leflunomide noted in 9 of 27 dogs (33%) included vomiting, diarrhea, lethargy, decreased or absent appetite, polyuria and polydipsia, and secondary antibiotic responsive infection and were self-limiting or resolved with outpatient therapy. Alkaline phosphatase (ALP) and alanine aminotransferase (ALT) elevation were documented in all dogs prescribed leflunomide plus prednisone, with persistent liver enzyme elevation in 6 of 9 dogs (67%) and normalization after antibiotic therapy in 3 of 9 dogs (33%). The majority of dogs prescribed leflunomide plus NSAID (11/17 [65%] dogs) did not experience liver enzyme elevation; 2 of 17 (12%) dogs developed transient antibiotic-responsive liver enzyme elevations, and 4 of 17 (23%) dogs had persistent liver enzyme elevation. CLINICAL RELEVANCE: Leflunomide was well tolerated for long-term management of IMPA. A significant difference in liver enzyme elevation was identified between dogs prescribed prednisone versus NSAID in combination with leflunomide. Leflunomide with NSAID therapy resulted in less hepatotoxicity compared with leflunomide with prednisone.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/38608652/