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.
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.
Phytomedicine. 2020 Mar;68:153136. doi: 10.1016/j.phymed.2019.153136. Epub 2019 Nov 18.
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.
来氟米特（LEF）治疗类风湿关节炎（RA）患者的停药率较高，可能是由于其不耐受，而不是不负责任。在治疗 RA 期间，同时给予来氟米特（LEF）与中草药（CHM），为预防 LEF 引起的不良反应（ADR）提供了一种潜在的解决方案。
探讨 LEF 与 CHM 联合应用是否能在提高治疗效果的同时减少 ADR，这是基于整体治疗水平的框架。
根据最近的论文介绍了 LEF 在 RA 治疗中的作用机制及其引起的 ADR。通过报告 LEF 与 CHM 联合应用的临床实例，为其提供了更多的证据。通过对 LEF 与 CHM 联合治疗的研究，提出了 LEF 引起的 ADR 的管理建议。
活性成分、化合物和草药在与 LEF 联合使用时都具有减轻毒性和减少 ADR 的作用，并在几个临床病例中得到了报道。然而，RA 的发病机制复杂，需要进一步的科学依据进行诊断和治疗，这阻碍了 CHM 与 LEF 联合应用的广泛应用。
本综述介绍了采用 CHM 作为 LEF 引起的 ADR 管理的新策略正在出现。
