The results reported here contrast with the
results of two trials of leflunomide at a dose of
20 mg per day as compared with methotrexate
(to a maximum dose of 15 mg per week) in patients
with long-standing rheumatoid arthritis.
In one trial,24 clinical, functional, and radiographic
responses were similar with the two
medications. In the second trial,25 ACR responses
were not reported, but improvement in tender
and swollen joints, as well as patient’s and physician’s
global assessments, were similar with the
two treatments; methotrexate appeared to be
more effective in decreasing radiographic progression.
In a study of tocilizumab versus methotrexate,26
tocilizumab monotherapy was associated
with superior ACR 20, ACR 50, and ACR 70
responses as compared with methotrexate monotherapy,
but radiographs were not obtained.