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lüll Leflunomide use during the first 33 months after food and drug administration approval: experience with a national cohort of 3,325 patients Siva C; Eisen SA; Shepherd R; Cunningham F; Fang MA; Finch W; Salisbury D; Singh JA; Stern R; Zarabadi SAArthritis Rheum 2003[Dec]; 49 (6): 745-51OBJECTIVE: To describe leflunomide (LEF) use in a national cohort of 3,325 veterans. METHODS: Prescriptions for LEF and 9 disease-modifying antirheumatic drugs written between October 1998 and June 2001 at all Veterans Affairs (VA) medical centers were obtained from VA national databases. RESULTS: LEF was initiated with a loading dose of 100 mg daily for 3 days in 61% of patients, and 42% of patients discontinued LEF. LEF was more likely to be discontinued if a 3-day 100-mg loading dose was prescribed, patients were younger than 44 years or older than 75 years, or reported an annual family income <$60,000. Review of medical records of 291 discontinuers revealed that the most common reasons for discontinuation were inefficacy (30%), gastrointestinal symptoms (29%), medication noncompliance or lost to followup (14%), and elevated liver enzymes (5%). CONCLUSION: LEF is relatively safe in clinical practice. The VA's national databases provide an excellent, inexpensive resource for postmarketing evaluation of rheumatologic medications.|*Product Surveillance, Postmarketing/statistics & numerical data[MESH]|Adult[MESH]|Aged[MESH]|Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use[MESH]|Antirheumatic Agents/*therapeutic use[MESH]|Arthritis, Rheumatoid/*drug therapy[MESH]|Cohort Studies[MESH]|Databases, Factual[MESH]|Drug Approval[MESH]|Drug Therapy, Combination[MESH]|Female[MESH]|Hospitals, Veterans[MESH]|Humans[MESH]|Isoxazoles/*therapeutic use[MESH]|Leflunomide[MESH]|Male[MESH]|Middle Aged[MESH]|Military Medicine[MESH]|Treatment Failure[MESH]|United States[MESH]|United States Department of Veterans Affairs[MESH] |