leflunomide / Generic mfg. - LARVOL DELTA

All that aches is not psoriatic arthritis: Recognizing the co-existence of psoriasis and rheumatoid arthritis (AAD 2026) - "TNF-α inhibitors and methotrexate were the most commonly used systemic treatments, used in 21(65.6%) and 20 (62.5%) patients, respectively. Other systemic agents used included leflunomide (43.7%), hydroxychloroquine (40.6%), sulfasalazine (31.2%), abatacept (25%), Janus kinase inhibitors (18.75%), and tocilizumab (9.37%)...Two patients required additional systemic therapy for treatment of their psoriasis and were treated with guselkumab and apremilast. Two patients experienced psoriasis exacerbation with adalimumab. Patients with psoriasis may have co-existing seropositive rheumatoid arthritis, which has important implications for evaluation and treatment distinctive from psoriatic arthritis. Joint symptoms should prompt evaluation and consideration of a rheumatology referral, as treating rheumatoid arthritis can also improve psoriasis."

Dermatology • Immunology • Inflammatory Arthritis • Pain • Psoriasis • Psoriatic Arthritis • Rheumatoid Arthritis • Rheumatology • Seronegative Spondyloarthropathies

Upadacitinib-Induced Remission in Multicentric Reticulohistiocytosis: Expanding the Therapeutic Role of JAK Inhibition. (PubMed, Int J Mol Sci) - "Prior therapies (glucocorticoids, methotrexate, leflunomide) achieved suboptimal control...This case adds to the limited literature supporting JAK inhibition as a targeted option for refractory MRH, including multisystem disease with pulmonary involvement. Systematic evaluation of efficacy, durability, and safety is warranted."

Journal • Diabetes • Hepatology • Immunology • Infectious Disease • Interstitial Lung Disease • Metabolic Disorders • Oncology • Pneumonia • Primary Biliary Cholangitis • Pulmonary Disease • Respiratory Diseases

Tracheobronchial Stenosis in Granulomatosis With Polyangiitis: Immunosuppressant Use and Airway Dilation Frequency. (PubMed, ACR Open Rheumatol) - "Leflunomide use was associated with a lower frequency of tracheal dilations in patients with TBS-GPA. These findings support the need for further evaluation of leflunomide as a treatment option in this population."

Journal • Rare Diseases • Vasculitis

Targeting metabolic vulnerabilities in basal-like breast cancer (AACR 2026) - "To evaluate the dependency of these murine tumors on pyrimidine biosynthesis, we used leflunomide, an FDA-approved dihydroorotate dehydrogenase (DHODH) inhibitor...Notably, we found that kinase inhibitors with off-target activity against ENT1 sensitized cells to DHODH inhibition. These findings are currently being validated in vivo, which may support a strategy of co-targeting pyrimidine biosynthesis and the nucleotide salvage pathways to overcome resistance."

Breast Cancer • Oncology • Solid Tumor • Triple Negative Breast Cancer • SLC29A1

Treatment Strategies for IgG4-RD Patients With Superficial Organ Involvement (clinicaltrials.gov) - P=N/A | N=60 | Recruiting | Sponsor: Peking Union Medical College Hospital | N=90 ➔ 60 | Trial completion date: Dec 2024 ➔ Apr 2026 | Trial primary completion date: Dec 2024 ➔ Apr 2026

Enrollment change • Trial completion date • Trial primary completion date • Immunology • Inflammation

Mitochondrial fusion induced by Mdivi-1 and leflunomide alters cell proliferation and viability, steroidogenesis and oxidative stress in chicken ovarian cells. (PubMed, Poult Sci) - "In granulosa cells, both treatments enhanced progesterone secretion, supported by increased expression of STAR, 3BHSD, and CYP11A1. Finally, while Mdivi-1 did not alter reactive oxygen species (ROS) or ATP levels, leflunomide significantly reduced oxidative stress and increased ATP production. In conclusion, mitochondrial dynamics play a critical, cell-specific role in regulating hen ovarian physiology, influencing the balance between proliferation, metabolism, and steroidogenesis."

Journal • CCND1 • CYP19A1 • MFN2 • STAR

Clinical and Sonographic Pattern of Late-Onset and Early-Onset Rheumatoid Arthritis: Comparative Study. (PubMed, Clin Med Insights Arthritis Musculoskelet Disord) - "Regarding treatment patterns, methotrexate (MTX) was more commonly prescribed in the EORA group (67.1%) compared with the LORA group (37.5%), whereas leflunomide was used more in LORA (68.75%) compared with EORA (46.8%), with statistically significant difference. Moreover, patients with LORA exhibited a greater burden of comorbidities than those with EORA. Therefore, regular evaluation of inflammatory activity using MSUS, along with assessment of associated comorbid conditions, is recommended in patients with LORA."

Journal • Immunology • Inflammation • Inflammatory Arthritis • Musculoskeletal Diseases • Rheumatoid Arthritis • Rheumatology • CRP

Study of a lipid extract from Eryx snakes in rat adjuvant-induced arthritis under a therapeutic regimen: comparison with methotrexate and leflunomide. (PubMed, Inflammopharmacology) - "Semi-quantitative histological scoring confirmed that LEES effectively limited articular structural damage without inducing the hepato-splenic toxicity associated with methotrexate. These findings indicate that LEES possesses multimodal immunomodulatory and analgesic actions with a highly favorable tolerability profile, supporting its further preclinical development as a potential adjunct or alternative to existing therapies."

Journal • Preclinical • Immunology • Inflammatory Arthritis • Oncology • Pain • Rheumatology • IL10 • IL6 • TNFA

Biomimetic Nanoplatform for Targeted Glioblastoma Therapy via Concurrently Triggering GPX4/DHODH Mediated Ferroptosis. (PubMed, Adv Sci (Weinh)) - "Therefore, in the present study, a multifunctional nanoplatform, hollow mesoporous manganese dioxide (H-MnO2)-hemin-leflunomide@membrane (MHL@M), is proposed and fabricated...Both in vitro and in vivo results demonstrate that MHL@M has excellent tumor-targeting, TME-responsive, and ferroptosis activation capacities. This study provides a solid foundation for the development of ferroptosis-based therapeutic strategies for GBM."

Journal • Brain Cancer • Glioblastoma • Oncology • Solid Tumor • GPX4

Evaluation of the anti-inflammatory effect of ectoine-leflunomide combination in adjuvant-induced arthritis in rats, and its colonic protective action against leflunomide-induced gastrointestinal injury. (PubMed, Inflammopharmacology) - No abstract available

Journal • Preclinical • Gastroenterology • Gastrointestinal Disorder • Immunology • Rheumatology

Hepatitis B Reactivation During Leflunomide Therapy: The Importance of Pre-Immunosuppression Screening (APASL 2026) - No abstract available

Hepatitis B • Hepatology • Infectious Disease • Inflammation

Leflunomide in Previously Treated Metastatic Triple Negative Cancers (clinicaltrials.gov) - P1/2 | N=17 | Completed | Sponsor: Joseph Sparano | Active, not recruiting ➔ Completed

Trial completion • Breast Cancer • Hormone Receptor Positive Breast Cancer • Oncology • Solid Tumor • Triple Negative Breast Cancer • ER • HER-2 • PIK3CA

Parotid transcriptomics reveals modulation of gene expression linked to salivary function and inflammation in Sjögren's disease following leflunomide and hydroxychloroquine combination treatment (EULAR 2026) - No abstract available

Inflammation • Sjogren's Syndrome

Leflunomide Exposure Duration and Dose Are Not Associated with Incident or Progressive Interstitial Lung Disease in Rheumatoid Arthritis: A Longitudinal CT Study (EULAR 2026) - No abstract available

Longitudinal study • Immunology • Inflammatory Arthritis • Interstitial Lung Disease • Pulmonary Disease • Respiratory Diseases • Rheumatoid Arthritis • Rheumatology

EULAR recommendations for the management of rheumatoid arthritis with synthetic and biologic disease-modifying antirheumatic drugs: 2025 update. (PubMed, Ann Rheum Dis) - "These updated EULAR recommendations provide consensus on RA management based on currently available evidence regarding efficacy, safety, and cost."

Journal • Cardiovascular • Immunology • Inflammatory Arthritis • Oncology • Rheumatoid Arthritis • Rheumatology

Adverse events related to drug-drug interactions in tocilizumab combination therapy: a retrospective analysis and clinical implications. (PubMed, Front Med (Lausanne)) - "The most significant DDI-related AEs identified for specific TCZ drug combinations were as follows: with DMARDs (e.g., methotrexate, hydroxychloroquine, and leflunomide), occurrence of anti-cyclic citrullinated peptide (CCP) positivity, hand deformity, and pemphigus were observed; with glucocorticoids (specifically prednisone), pemphigus, hand deformity, glossodynia, and pericarditis should be monitored; with NSAIDs (specifically diclofenac), heightened vigilance is warranted for anti-CCP positive, rheumatic fever, duodenal ulcer perforation, and Helicobacter infections. Age and sex influence DDI risks: adults (≥18 years) were more susceptible to infusion reactions with TCZ + hydroxychloroquine or TCZ + sulfasalazine, and to joint swelling with TCZ + naproxen. Male patients demonstrated a higher incidence of stomatitis with TCZ + methotrexate, and of joint swelling with TCZ + ibuprofen or TCZ + naproxen. Female patients were more susceptible to infusion-related reactions..."

Adverse events • Journal • Retrospective data • Cardiovascular • Dental Disorders • Immunology • Infectious Disease • Musculoskeletal Diseases • Peptic Ulcer • Rheumatology • Stomatitis

Anti CD19 targeting CAR T cell therapy in ANCA-associated vasculitis. (PubMed, Rheumatology (Oxford)) - "CD19-targeted CAR T cell therapy was safe and efficacious in a patient with relapsed and refractory GPA. CAR T cell therapy has the potential to transform disease management and improve long-term outcomes for affected patients."

Journal • ANCA Vasculitis • Immunology • Inflammation • Rare Diseases • Vasculitis • CRP

External Ear Vasculitis Beyond Levamisole and Autoimmunity: An Infection-Associated Case (AAD 2026) - "We present the case of a 76-year-old woman from Medellín, Colombia, with a history of seropositive rheumatoid arthritis diagnosed in 2003, treated with methotrexate, chloroquine, leflunomide, and low-dose oral prednisolone. Varicella is an uncommon and underrecognized etiology of vasculitis in adults, and its overlap with autoimmune and levamisole-induced vasculitis poses a diagnostic challenge. To our knowledge, small-vessel vasculitis due to varicella is exceedingly rare, underscoring the value of tissue biopsy and reminding clinicians that not all vasculitis are autoimmune in origin."

Clinical • Cardiovascular • Immunology • Infectious Disease • Inflammatory Arthritis • Rheumatoid Arthritis • Varicella Zoster • Vasculitis

Therapeutic effect of tofacitinib combined with leflunomide for refractory Takayasu arteritis: pilot study. (PubMed, Semin Arthritis Rheum) - "The regimen of TOF combined with LEF might be a promising novel option in treating refractory TAK patients."

Journal • Rheumatology • Vasculitis

REDUCED-TOXICITY MYELOABLATIVE TBI-BASED CONDITIONING FOR ≥2-MISMATCH PARTIALLY MATCHED RELATED DONOR HSCT WITH PTCY IN HIGH-RISK HEMATOLOGICAL MALIGNANCIES: SINGLE-CENTRE REAL-WORLD OUTCOMES FROM INDIA (EBMT 2026) - "Background: Partially matched related donor (PMRD) HSCT with post-transplant cyclophosphamide (PTCy) broadens access to allogeneic transplantation...Conditioning comprised fludarabine–TBI 8 Gy (predominantly ALL) and fludarabine–melphalan 75 mg/m²–TBI 4 Gy...Program specific modifications adapted from earlier clinical experience of program leads included (i) early UGIE for upper-GI symptoms enabling prompt diagnosis of predominantly upper-GI aGVHD, (ii) planned early immunosuppression taper/withdrawal (typically by ~day 60) to augment graft-versus-leukemia effect, (iii) universal prophylactic/pre-emptive granulocyte transfusions for all patients, and (iv) a resource-adapted CMV strategy with off-label leflunomide-based pre-emptive management for low-level CMV DNAemia before letermovir availability...CMV reactivation occurred in 5/10 and BK virus in 2/10; TA-TMA occurred in 1/10 (resolved with Rituximab , Narsoplimab) and VOD/SOS in 0/10... An RT-MAC TBI-based..."

Clinical • Real-world • Real-world evidence • Acute Graft versus Host Disease • Bone Marrow Transplantation • Chronic Graft versus Host Disease • Graft versus Host Disease • Hematological Malignancies • Immunology • Infectious Disease • Leukemia • Oncology

Association of Disease-Modifying Antirheumatic Drugs (DMARDs) with Cardiovascular Diseases: Evidence from a Drug Target Mendelian Randomization Study. (PubMed, Glob Heart) - "Genetic instruments were employed to proxy the pharmacological effects of seven DMARD classes, including sulfasalazine, cyclosporine, leflunomide, IL-6 inhibitors, TNF-alpha inhibitors, abatacept, rituximab, and JAK inhibitors. Overall, this study presents evidence supporting a causal association between DMARDs and several CVDs. Nevertheless, further clinical investigations are necessary to validate our findings."

Journal • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Heart Failure • Inflammation • Ischemic stroke • Myocardial Infarction • CD80 • IL6R • RELA

BIO3: Clinical Trial Evaluating Methotrexate or Leflunomide + Targeted Therapy Versus Methotrexate or Leflunomide + Sulfasalazine + Hydroxychloroquine in Patients with Rheumatoid Arthritis and Insufficient Response to Methotrexate or Leflunomide (clinicaltrials.gov) - P4 | N=286 | Recruiting | Sponsor: University Hospital, Strasbourg, France | Trial completion date: Mar 2022 ➔ Mar 2025 | Trial primary completion date: Mar 2022 ➔ Mar 2025

Trial completion date • Trial primary completion date • Immunology • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology

BIO3: Clinical Trial Evaluating Methotrexate or Leflunomide + Targeted Therapy Versus Methotrexate or Leflunomide + Sulfasalazine + Hydroxychloroquine in Patients with Rheumatoid Arthritis and Insufficient Response to Methotrexate or Leflunomide (clinicaltrials.gov) - P4 | N=286 | Recruiting | Sponsor: University Hospital, Strasbourg, France | Trial completion date: Mar 2025 ➔ Mar 2029 | Trial primary completion date: Mar 2025 ➔ Mar 2029

Trial completion date • Trial primary completion date • Immunology • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology

Rituximab for active Rhupus syndrome with severe thrombocytopenia after multiple DMARD failures: a case report (LUPUS 2026) - "Management included MTX 25 mg weekly (since 2010), leflunomide (2014–2018, leukopenia), sulfasalazine 2 g/day (2018–2020, leukopenia), hydroxychloroquine (since 2018), intermittent glucocorticoid tapers, and biologics—tocilizumab 162 mg weekly (2021–2024, inadequate response) and upadacitinib 15 mg/day (stopped July 2025 for thrombocytopenia).During hospitalization in the rheumatology clinic, physical examination showed a positive squeeze test at PIP3 and MCP1–3 of the right hand and MCP1–2 of the left hand. Treatment was well tolerated.Abstract PO:04:106 Figure 1 Conclusions Cytopenias are common in Rhupus/SLE and may be more pronounced in Asian populations. This case supports the potential role of rituximab in Rhupus complicated by severe thrombocytopenia, demonstrating prompt clinical and laboratory responses after failure of multiple DMARDs/biologics."

Case report • Clinical • Immunology • Inflammatory Arthritis • Rheumatoid Arthritis

Oral soft tissue manifestations in patients with rheumatoid arthritis undergoing antirheumatic therapy: a scoping review. (PubMed, Odontology) - "Methotrexate was the most frequently used agent, followed by leflunomide, sulfasalazine, hydroxychloroquine, and corticosteroids. In summary, oral manifestations represent clinically relevant yet underrecognized adverse effects of antirheumatic therapy in RA. Strengthening collaboration between rheumatologists and oral medicine specialists is crucial for early recognition, accurate differential diagnosis, and prevention of severe outcomes."

Journal • Review • Dental Disorders • Immunology • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology • Stomatitis • Xerostomia