Does Leflunomide increase the suceptibility to infection to tuberculosis? Should it be used in persons having chronic infections like Tuberculosis?
In the RA patient population, we have not seen an increase incidence of TB with leflunomide or methotrexate. Thus most rheumatologists do not screen for latent TB with a PPD prior to starting one of those agents– unlike with starting a TNF agent (Enbrel, Humira, Remicade), in which PPD is mandatory. however ir remains a theoretical risk and thus treatment for latent TB should be considered in patients who are PPD positive.