Leflunomide as a potential second-line drug in the treatment of sarcoidosis

Sarcoidosis is systemic granulomatosis of an unknown nature, the course of which varies from spontaneous remission to progression resulting in failure of organs and systems. The article presents a review of current approaches to treatment of sarcoidosis putting special emphasis on the use of the ant...

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Main Authors: A. A. Vizel, I. Yu. Vizel
Format: Article
Language:Russian
Published: New Terra Publishing House 2019-09-01
Series:Туберкулез и болезни лёгких
Subjects:
Online Access:https://www.tibl-journal.com/jour/article/view/1326
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author A. A. Vizel
I. Yu. Vizel
author_facet A. A. Vizel
I. Yu. Vizel
author_sort A. A. Vizel
collection DOAJ
description Sarcoidosis is systemic granulomatosis of an unknown nature, the course of which varies from spontaneous remission to progression resulting in failure of organs and systems. The article presents a review of current approaches to treatment of sarcoidosis putting special emphasis on the use of the anti-rheumatic drug of leflunomide (LEF). LEF is a prodrug derived from isoxazole, which is rapidly converted by liver and intestinal wall into an active metabolite, A77-1726, which inhibits the biosynthesis of pyrimidine nucleotides. LEF slows down the cell cycle, inhibits the activity of the mitochondrial enzyme dihydroorotate dehydrogenase, a key enzyme in the primary (de novo) synthesis of pyrimidines used by lymphocytes for clonal expansion. There are English reports on 2 retrospective studies of LEF used to manage sarcoidosis refractory to traditional therapy and a number of descriptions of clinical cases that provided encouraging results. LEF was found to be safer than methotrexate with comparable efficacy in both rheumatoid arthritis and sarcoidosis. Literature data indicate the feasibility of studying leflunomide in clinical practice of sarcoidosis.
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series Туберкулез и болезни лёгких
spelling doaj-art-bcc407a799ac4615b72244ab6b378f742025-08-20T02:16:01ZrusNew Terra Publishing HouseТуберкулез и болезни лёгких2075-12302542-15062019-09-01978525810.21292/2075-1230-2019-97-8-52-581326Leflunomide as a potential second-line drug in the treatment of sarcoidosisA. A. Vizel0I. Yu. Vizel1Kazan State Medical UniversityKazan State Medical University; Central Tuberculosis Research InstituteSarcoidosis is systemic granulomatosis of an unknown nature, the course of which varies from spontaneous remission to progression resulting in failure of organs and systems. The article presents a review of current approaches to treatment of sarcoidosis putting special emphasis on the use of the anti-rheumatic drug of leflunomide (LEF). LEF is a prodrug derived from isoxazole, which is rapidly converted by liver and intestinal wall into an active metabolite, A77-1726, which inhibits the biosynthesis of pyrimidine nucleotides. LEF slows down the cell cycle, inhibits the activity of the mitochondrial enzyme dihydroorotate dehydrogenase, a key enzyme in the primary (de novo) synthesis of pyrimidines used by lymphocytes for clonal expansion. There are English reports on 2 retrospective studies of LEF used to manage sarcoidosis refractory to traditional therapy and a number of descriptions of clinical cases that provided encouraging results. LEF was found to be safer than methotrexate with comparable efficacy in both rheumatoid arthritis and sarcoidosis. Literature data indicate the feasibility of studying leflunomide in clinical practice of sarcoidosis.https://www.tibl-journal.com/jour/article/view/1326leflunomidesarcoidosisrefractivitytreatment
spellingShingle A. A. Vizel
I. Yu. Vizel
Leflunomide as a potential second-line drug in the treatment of sarcoidosis
Туберкулез и болезни лёгких
leflunomide
sarcoidosis
refractivity
treatment
title Leflunomide as a potential second-line drug in the treatment of sarcoidosis
title_full Leflunomide as a potential second-line drug in the treatment of sarcoidosis
title_fullStr Leflunomide as a potential second-line drug in the treatment of sarcoidosis
title_full_unstemmed Leflunomide as a potential second-line drug in the treatment of sarcoidosis
title_short Leflunomide as a potential second-line drug in the treatment of sarcoidosis
title_sort leflunomide as a potential second line drug in the treatment of sarcoidosis
topic leflunomide
sarcoidosis
refractivity
treatment
url https://www.tibl-journal.com/jour/article/view/1326
work_keys_str_mv AT aavizel leflunomideasapotentialsecondlinedruginthetreatmentofsarcoidosis
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