The role of Chinese herbal medicine in the management of adverse drug reactions of leflunomide in treating rheumatoid arthritis.


Journal

Phytomedicine : international journal of phytotherapy and phytopharmacology
ISSN: 1618-095X
Titre abrégé: Phytomedicine
Pays: Germany
ID NLM: 9438794

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 19 07 2019
revised: 30 10 2019
accepted: 17 11 2019
pubmed: 18 2 2020
medline: 12 5 2020
entrez: 17 2 2020
Statut: ppublish

Résumé

The high discontinuation rate in RA patients who use LEF might be attributed to their intolerance rather than irresponsibility. The concomitant administration of Leflunomide (LEF) with Chinese herbal medicine (CHM) provides a potential solution to preventing the adverse drug reactions (ADRs) induced by LEF during the treatment of rheumatoid arthritis (RA). To investigate whether co-administration of LEF with CHM could bring in both increased therapeutic outcomes and reduced ADRs due to the framework of treatment at the level of entire body. The mechanism of LEF in RA treatment and the ADRs it induced was introduced based on recent papers. Reported clinical examples of CHM concurrent use with LEF was revealed to provide more evidence. The management of the ADRs caused by LEF was suggested by current researches on the concomitant therapy of CHM with LEF. The active ingredients, compounds and medicinal herbs all demonstrated properties in relieving toxicities and reducing ADRs when used with LEF and reported in several clinical cases. The wide application of concurrent use of CHM with LEF is however hindered by the complex pathogenesis of RA which requires further scientific grounds for diagnosis and treatment. This review introduced that the adoption of CHM is emerging as a novel strategy for the management of ADRs caused by LEF.

Sections du résumé

BACKGROUND BACKGROUND
The high discontinuation rate in RA patients who use LEF might be attributed to their intolerance rather than irresponsibility. The concomitant administration of Leflunomide (LEF) with Chinese herbal medicine (CHM) provides a potential solution to preventing the adverse drug reactions (ADRs) induced by LEF during the treatment of rheumatoid arthritis (RA).
PURPOSE OBJECTIVE
To investigate whether co-administration of LEF with CHM could bring in both increased therapeutic outcomes and reduced ADRs due to the framework of treatment at the level of entire body.
STUDY DESIGN METHODS
The mechanism of LEF in RA treatment and the ADRs it induced was introduced based on recent papers. Reported clinical examples of CHM concurrent use with LEF was revealed to provide more evidence. The management of the ADRs caused by LEF was suggested by current researches on the concomitant therapy of CHM with LEF.
RESULTS RESULTS
The active ingredients, compounds and medicinal herbs all demonstrated properties in relieving toxicities and reducing ADRs when used with LEF and reported in several clinical cases. The wide application of concurrent use of CHM with LEF is however hindered by the complex pathogenesis of RA which requires further scientific grounds for diagnosis and treatment.
CONCLUSION CONCLUSIONS
This review introduced that the adoption of CHM is emerging as a novel strategy for the management of ADRs caused by LEF.

Identifiants

pubmed: 32062477
pii: S0944-7113(19)30452-0
doi: 10.1016/j.phymed.2019.153136
pii:
doi:

Substances chimiques

Antirheumatic Agents 0
Drugs, Chinese Herbal 0
Leflunomide G162GK9U4W

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

153136

Informations de copyright

Copyright © 2019. Published by Elsevier GmbH.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no conflict of interest.

Auteurs

Wanying Wang (W)

Faculty of Chinese Medicine/State Key Laboratory of Quality Research in Chinese Medicine/Institute of Rheumatic Diseases, Macau University of Science and Technology, Avenida Wailong, Taipa, Macau, PR China.

Hua Zhou (H)

Faculty of Chinese Medicine/State Key Laboratory of Quality Research in Chinese Medicine/Institute of Rheumatic Diseases, Macau University of Science and Technology, Avenida Wailong, Taipa, Macau, PR China; Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, PR China.

Liang Liu (L)

Faculty of Chinese Medicine/State Key Laboratory of Quality Research in Chinese Medicine/Institute of Rheumatic Diseases, Macau University of Science and Technology, Avenida Wailong, Taipa, Macau, PR China. Electronic address: lliu@must.edu.mo.

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Classifications MeSH