Do you combine methotrexate and leflunomide for the treatment of RA?

Absolutely! What a coincidence, as I was just communicating by email with a patient with horrible hard-to-control psoriatic arthritis (PsA) who failed numerous combos and biologics. (I know this question is RA, but also think of LEF with PsA).

It was not until I added leflunomide (LEF) to her regime...

I agree with my colleagues Drs. @Dr. First Last and @Dr. First Last. This combination can be used safely and with good efficacy in RA and PSA patients, particularly those that have failed multiple agents or cannot utilize biologic therapy due to cost, other health issues, etc. There are a few studie...

@Dr. First Last... great question!

1. I completely understand why many rheumatologists would prefer not to use a loading dose (dealing with increased side effects).

2. However, I always questioned the validity of these results. Why would there be a higher response (ACR 20, by the way, not ACR 50 nor...