In order to minimize the risks of infection and other potential complications with podiatric surgery in this patient population, this author reviews the literature and offers insights on whether medications for RA should be withdrawn, continued or modified during the perioperative period. Increasingly, the treatment of rheumatoid arthritis includes the utilization of immunosuppressive therapeutic agents. Side effects of plaquenil and prednisone Side effects of plaquenil on the eyes Does plaquenil cause leg cramps Leflunomide Arava® may also raise your risk of getting infections. Let your doctor know if you have signs of an infection, like fever or chills. Hydroxychloroquine Plaquenil® Hydroxychloroquine Plaquenil® is used for rheumatoid arthritis and systemic lupus erythematosus. Leflunomide Arava is an older DMARD that helps reduce pain and swelling due to RA. It may be given in addition to methotrexate, if methotrexate alone is inadequate to control the progression of RA. Conventional DMARDs that have been paired with methotrexate include sulfasalazine, hydroxychloroquine, cyclosporine, leflunomide and azathioprine. Although studies of these combinations have shown differing levels of benefit, the combinations of methotrexate plus leflunomide and methotrexate plus sulfasalazine are among the most effective. Louie and Ward demonstrated that in the state of California, rates of joint surgery for the treatment of RA declined in the 1990s and have continually diminished since that time.1 The authors concluded that the favorable long-term outcomes for the treatment of rheumatoid arthritis with newer agents have resulted in a decreased need for bone and joint surgery in patients afflicted with this disease. The effectiveness of disease modifying agents in reversing the progression of rheumatoid arthritis (RA) is illustrated by the reduced frequency with which patients with RA undergo surgery for bone and joint deformities. Methotrexate sulfasalazine hydroxychloroquine and leflunomide Combination Therapy for Rheumatoid Arthritis in the Era of., Rheumatoid Arthritis Treatment Side Effects Macular society hydroxychloroquine Background/Purpose The combination of methotrexate MTX, sulfasalazine SSZ and hydroxychloroquine HCQ triple therapy is a highly effective and well-tolerated treatment in rheumatoid arthritis RA. While MTX is the cornerstone of most successful combination therapies, not all patients are candidates for, or tolerate, MTX. Leflunomide, a disease-modifying anti-rheumatic drug DMARD. Leflunomide, Sulfasalazine and Hydroxychloroquine for.. DMARDs Arthritis Foundation. The Combination of Leflunomide Arava and Methotrexate is.. Objective To determine the survival and clinical effectiveness of leflunomide LEF compared with methotrexate MTX and sulfasalazine SSZ for RA in an observational study. Methods An observational database of 1088 patients and 5141 patient years. Sep 01, 2003 Leflunomide is a new drug with a different mechanism of action than other DMARDs such as methotrexate, antimalarial drugs chloroquine and hydroxychloroquine, sulfasalazine, gold, azathioprine. Individualization of Leflunomide Dosing in Rheumatoid Arthritis Patients. with methotrexate and hydroxychloroquine when leflunomide is added to triple therapy. of the sulfasalazine.