{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:23:05Z","timestamp":1785338585326,"version":"3.55.0"},"reference-count":18,"publisher":"The Journal of Rheumatology","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>To describe a clinical practice with leflunomide (LEF) in juvenile idiopathic arthritis (JIA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>Patients with JIA seen between May 2008 and May 2012 and considered nonresponsive to methotrexate (MTX) were given LEF and prospectively followed. Primary outcome was a 28-joint Disease Activity Score (DAS28) of low disease activity (&lt; 3.2) in less than 6 months. Childhood Health Assessment Questionnaire (CHAQ) scores and safety data were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Forty-three patients (33 female) were included with 25 (58.1%) polyarticular, 10 oligoarticular (7 extended; 3 persistent), 6 systemic, and 2 enthesitis-related. Ten (23.2%) were rheumatoid factor\u2013positive and 7 (16.3%) had antinuclear antibodies. Prior drugs other than MTX: 11 (25.5%) chloroquine diphosphate + MTX and 2 (4.6%) sulfasalazine + MTX; mean prednisone dose was 6.4 \u00b1 9.3 mg. The MTX dose prior to LEF was 14.5 \u00b1 4.5 mg\/m<jats:sup>2<\/jats:sup>\/week. LEF dose and duration of therapy were 16.6 \u00b1 5.2 mg\/d and 3.6 \u00b1 2.2 years, respectively. Nineteen patients (44.2%) interrupted LEF: 1 entered remission, 11 were nonresponsive, and 7 were intolerant (16.2%). Baseline DAS28 (5.57 \u00b1 0.7) dropped to 3.7 \u00b1 1.2 at final analysis (p &lt; 0.001) and 16 patients (37.2%) had a low DAS28 [&lt; 3.2; 12 (27.9%) while taking LEF + MTX and 4 (9.3%) while taking monotherapy]. At last followup, the number of patients with DAS28 &gt; 5.1 dropped from 34 (79%) to 9 (20.9%) and CHAQ scores from 0.86 \u00b1 0.7 to 0.44 \u00b1 0.5 (p &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>LEF isolated or combined with MTX is effective and safe to treat JIA in patients refractory to MTX.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.130294","type":"journal-article","created":{"date-parts":[[2013,12,15]],"date-time":"2013-12-15T20:14:20Z","timestamp":1387138460000},"page":"338-344","source":"Crossref","is-referenced-by-count":16,"title":["A Longterm Prospective Real-life Experience with Leflunomide in Juvenile Idiopathic Arthritis"],"prefix":"10.3899","volume":"41","author":[{"given":"Antonia C\u00e9lia de Castro","family":"Alc\u00e2ntara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane Ara\u00fajo 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