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I've been taking Arava (leflunomide) for about 15 years now and it works 99% of the time. It took about 6 weeks to get into my system and start working. If I forget to take it one day my RA becomes painful a week or so later. I use prednisone as a back up just in case it quits working or I forget to take it...which is about 3-4 times a year. The price of this medicine came down dramatically about 6-8 years ago, if memory serves me. My doctor also does kidney function tests on me twice a year... used to be 6 times a year in the beginning.