Leflunomide in systemic onset juvenile idiopathic arthritis

Methotrexate, the mainstay of treatment in Juvenile idiopathic arthritis, might not be effective in a few patients of polyarticular and systemic onset juvenile idiopathic arthritis. Use of biologicals like TNF-alpha blockers, the next line of preferred drugs is constrained by the high cost. We successfully used leflunomide in four patients.