Upon my last visit to the rheumatologist, he suggested if I’m not seeing results from my current meds I can try Arava. “Never heard of that one before”, I said. Some patients have had success he tells me, and since I’ve already tried methotrexate without any luck this apparently is the next step.

But how do I go about taking yet another new prescription without still knowing what I am treating? Besides having one clue (a brother with severe psoriasis), not one of my relatives has had a case like mine. And most of my grandparents and their parents are no longer here to ask. Sometimes I wish I knew to ask questions while they were still here. As far as I know there were a few cases of osteoarthritis, but nothing of the autoimmune variety.

So that leads me back to the next step in my investigation… or should I say treatment. Arava, or Leflunomide for those of us who like tongue twisters, is bright red on my hesitation radar. Anytime I notice severe liver injury as a possible side effect it makes me think twice. Not to mention it still feels like a treatment of symptoms rather than going after the cause. Another concern is the notation that Arava may remain in the body for up to 2 years after you stop taking it. I could go on and on about the other possible side effects or how many warnings mention the word fatal, but that seems to be the norm with most of the drugs used to treat rheumatoid arthritis or various other inflammatory autoimmune diseases.

After some searching, Arava appears to be controversial. When the FDA updates a medication with a box warning specifying, “risk of severe liver injury”, it makes me more than a little uneasy. Further details about the warning explain that death from liver failure  in over a dozen patients on the drug coincided with other medications they were taking that affect the liver. Regardless of how many other medications were involved, Arava has a definite affect on the body. I will continue to research Arava and other options in my quest to make an informed decision, but for now the side effects of this drug outweigh the symptoms I already experience.