Teriflunomide for multiple sclerosis in real-world setting

Acta Neurol Scand. 2017 Nov;136(5):447-453. doi: 10.1111/ane.12755. Epub 2017 Mar 20.

Abstract

Objectives: Teriflunomide 14 mg is a once-daily oral disease-modifying treatment for relapsing-remitting multiple sclerosis. We examined adverse event (AE) profile and efficacy in real life.

Materials and methods: In this observational cohort study, we retrospectively examined 1521 blood samples and data of 102 patients followed for up to 28 months.

Results: The number of female patients starting teriflunomide peaked in the fifth decade, 10 years later compared to male patients (P<.001), reflecting pregnancy concerns. Seventy-six percentages of patients shifted to teriflunomide from treatment with interferon-beta. Expanded disability status scale improved in 11% of patients (18.2±3.6 months follow-up) and remained constant in 67.5% (15±5.3 months follow-up). Of ten relapses, three occurred within 6 months after starting treatment. Seventeen patients (16.5%) discontinued teriflunomide: 53% because of AEs and 29% because of relapse. Levels of alanine aminotransferase (ALT) remained normal in 95.3% of the blood samples and remained below 1.5 times the upper limit of normal in 91% of the 4.7% abnormal samples. One-third of the patients had abnormal ALT values at least once. Haematological abnormalities were found in <4% of the blood samples, but at least one abnormal value was observed in up to 21% of the patients.

Conclusions: Efficacy and safety of teriflunomide in real-life setting support data obtained by the pivotal trials. Laboratory abnormalities are rare among the large number of samples, but patients may commonly have a single mild, abnormal value if frequently tested.

Keywords: adverse effects; demyelinating diseases efficacy; multiple sclerosis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Crotonates / administration & dosage
  • Crotonates / adverse effects
  • Crotonates / therapeutic use*
  • Female
  • Humans
  • Hydroxybutyrates
  • Male
  • Multiple Sclerosis, Relapsing-Remitting / blood
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Nitriles
  • Toluidines / administration & dosage
  • Toluidines / adverse effects
  • Toluidines / therapeutic use*

Substances

  • Crotonates
  • Hydroxybutyrates
  • Nitriles
  • Toluidines
  • teriflunomide
  • Alanine Transaminase