Arava and Psoriatic Arthritis

If you have rheumatoid arthritis, you probably already know about Arava. But did you know that healthcare providers sometimes prescribe Arava for psoriatic arthritis as well? Though not approved for this use, this drug can be helpful for people who are unable to take other medications, such as cyclosporine. However, it is not without risks, such as an increased risk of infections and liver damage.

Using Arava for Psoriatic Arthritis

Arava® (leflunomide) is a medication approved to treat rheumatoid arthritis. It is sometimes used in an off-label (unapproved) manner for the treatment of psoriatic arthritis. As with many psoriatic arthritis treatments, it carries the risk of some very serious side effects.

Risks of Treating Psoriatic Arthritis With Arava

While Arava can be a good option for some individuals, it is not without risk. Some of the more important and serious risks of taking Arava (for any use) include the following:
  • This medication can cause severe liver damage. People with liver disease, or those with elevated liver enzymes, are at an increased risk for this side effect and, therefore, should not take Arava.
  • Arava suppresses the immune system, which may increase your risk for developing an infection, including potentially serious infections.
  • There have been reports of low blood cell counts, such as low platelets and low white blood cells, in people taking Arava. Depending on the type of blood cell affected, this could increase your risk for developing an infection or experiencing a dangerous bleeding problem.

Arava's Role in Psoriatic Arthritis Treatment

Arava certainly isn't "first line" or "gold standard" therapy for psoriatic arthritis, largely due to the lack of large, well-designed studies of the drug for this use. Somewhat similar medications, methotrexate and cyclosporine, are much more commonly used and have more evidence to support their use. However, some people do not respond adequately to methotrexate or cyclosporine or cannot take the drugs due to dangerous or intolerable side effects. In such situations, Arava may be a good alternative.
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