A retrospective cohort study published in SAGE Open Chronic Disease compared the effectiveness and safety of leflunomide and methotrexate in 167 DMARD-naive patients aged ≥65 years with rheumatoid arthritis. The study included 80 patients treated with leflunomide and 87 treated with methotrexate, with outcomes assessed over 24 weeks. Methotrexate produced a significantly greater reduction in disease activity than leflunomide, with a median DAS28-CRP reduction of 1.9 versus 0.7 (p<0.001). However, remission rates (37.9% vs.
31.3%) and low disease activity rates (82.8% vs. 73.8%) were comparable between groups. Swollen joint count was significantly associated with remission in both treatment groups (p<0.001). After adjustment for baseline disease activity, methotrexate was associated with a 73% lower risk of treatment discontinuation (adjusted HR: 0.27; 95% CI: 0.13–0.54; p<0.001).…
