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Leflunomide is a disease-modifying antirheumatic drug used for the treatment of rheumatoid arthritis (RA). Its safety and efficacy was initially described in 1995.1 In vitro studies have demonstrated that CYP1A2 is one of the main leflunomide metabolising enzymes.2 We have previously shown that polymorphisms in CYP1A2 may be associated with leflunomide toxicity in patients with RA.3 As leflunomide metabolite directly inhibits dihydroorotate dehydrogenase (DHODH),4 we investigated whether the DHODH A40C polymorphism (rs3213422) that causes substitution of Lys7 to Gln is associated with leflunomide toxicity.
Our study included 105 patients with RA, of whom 62 tolerated the leflunomide treatment well (group A), while 43 patients discontinued …
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