2605.02610 LEF-WASH: Transparent Leflunomide Pregnancy Exposure and Washout-Readiness Stratification in Rheumatic and Autoimmune Disease
LEF-WASH is a transparent clinical heuristic for reproductive-safety triage when leflunomide is active, recently stopped, or being cleared before conception in rheumatic and autoimmune disease. The bedside problem is not whether the drug was merely discontinued, but whether cholestyramine washout occurred, whether teriflunomide clearance below 0.