Rheumatology Advance Access originally published online on April 4, 2007
Rheumatology 2007 46(7):1047-1048; doi:10.1093/rheumatology/kem050
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
EDITORIALS |
Leflunomide versus methotrexate in Wegener's granulomatosis
Department of Medicine, School of Clinical Medicine, Addenbrooke's Hospital, Box 157, Cambridge CB22QQ, UK
Correspondence to: David Jayne. E-mail: dj106@cam.ac.uk
| The first 10% of the full text of this article appears below. |
Wegener's granulomatosis has major overlaps with other primary systemic vasculitides, especially microscopic polyangiitis, but also important differences [1]. Its cause is unknown, but it almost always involves the respiratory tract and is more common in cooler latitudes [2]. It typically pursues a protracted relapsing course resulting in chronic morbidity for the patient and an ever widening search for newer, safer therapies by their physician. Combination therapy with cyclophosphamide and corticosteroids, first introduced 35 yrs ago, revolutionized the treatment of Wegener's granulomatosis and converted a frequently fatal disorder into a more chronic relapsing condition [3]. Subsequent clinical investigation has aimed to reduce drug-related toxicity, reduce relapse rates and recover organ function. In particular, the failure of short treatment regimens to induce prolonged disease