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Rheumatology 2000; 39: 689-692
© 2000 British Society for Rheumatology

Editorials

Leflunomide, a new disease-modifying anti-rheumatic drug and the never ending rheumatoid arthritis story

J. S. Smolen1,2,, W. B. Graninger1 and P. Emery3

1 Department of Rheumatology, Internal Medicine III, Vienna General Hospital, University of Vienna,
2 Second Department of Medicine—Centre for the Rheumatic Diseases, Lainz Hospital, Vienna, Austria and
3 Rheumatology and Rehabilitation Research Unit, University of Leeds, Leeds, UK

The first 150 words of the full text of this article appear below.

The standard approach to the therapy of rheumatoid arthritis (RA) has been revised during the last decade. Traditionally a treatment pyramid [1, 2] was used but this has been challenged [3–9]. In particular, the original philosophy which fostered a ‘wait and see [with or without non-steroidal anti-inflammatory drugs (NSAIDs)]’ attitude has been taken apart and replaced by the demand ‘Treat now, not later!’ [10]. As a result, disease-modifying anti-rheumatic drugs (DMARDs) are now initiated more as early in the disease course as possible, i.e. as soon as an accurate diagnosis is made [10–12]. Many issues are unresolved, including: (a) the definition of ‘early RA’, since most studies of so-called early RA have dealt with patients who had the disease for 1, 2 or even more years [13]; (b) how to reduce the period between onset . . . [Full Text of this Article]


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