Highlights
- •Teriflunomide use has progressively increased for treatment of Multiple Sclerosis (MS).
- •In the last two years, we described a 20% and 10% increase of its use in naïve patients and young women.
- •The efficacy goal of NEDA-3 at 24 and 36 months was achieved in more than 55% patients.
- •An adequate shared decision-making process is necessary to identify the best candidate patient.
Abstract
Objectives
The present study aims to describe the evolution of teriflunomide use for multiple
sclerosis (MS) in the clinical setting, in particular for naïve patients and young
women. Predictors of treatment response were also investigated.
Methods
This was an independent, retrospective, real-world monocentric study. We analysed
the use of teriflunomide from 2016 to 2020 in patients categorized as naïve or switchers,
and assessed the variations in its use in men and women by age group. Clinical and
MRI data of treated patients were evaluated, and NEDA-3 status at 24 and 36 months
was defined. Determinants of therapeutic response were examined using regression analysis.
Results
The study included 319 MS patients exposed to teriflunomide [209 women (65.5%)]. Of
these, 67 (21%) were naïve and 252 (79%) were switchers. A 20% increase of teriflunomide
use in the naïve group in the past two years, particularly in 2020, the first year
of global Sars-Cov-2 spread, was observed. An increase of teriflunomide use of more
than 10% in young women under age 45 was also reported. NEDA-3 status was calculated
for 204 patients after 24 months and was achieved in 120 (58.8%) of these ones. NEDA-3
was also achieved in 92/160 (56.8%) patients at 36 months. A lower ARR in the two
years prior to teriflunomide treatment (p = 0.026), lower baseline age (p = 0.05), and lower EDSS score (p = 0.009) were associated with achievement of the NEDA-3.
Conclusions
Our study confirms a major evolution in teriflunomide use in clinical settings, particularly
for naïve patients and young women.
Keywords
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References
- Multiple sclerosis.Handb. Clin. Neurol. 2016; 135: 399-423
- Optimizing therapy early in multiple sclerosis: an evidence-based view.Mult. Scler. Relat. Disord. 2015 Sep; 4: 460-469
- Towards personalized therapy for multiple sclerosis: limitations of observational data.Brain. 2018 May 1; 141e38
- Teriflunomide and its mechanism of action in multiple sclerosis.Drugs. 2014 Apr; 74: 659-674
- Biodistribution of teriflunomide in naïve rats vs rats with experimental autoimmune encephalomyelitis.in: Presented at Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). 2015
- An updated review of teriflunomide’s use in multiple sclerosis.Neurodegener. Dis. Manag. 2021 Oct; 11: 387-409
- Patient-reported outcomes in relapsing forms of MS: real-world, global treatment experience with teriflunomide from the Teri-PRO study.Mult. Scler. Relat. Disord. 2017 Oct; 17: 107-115
- Teriflunomide: pediatric first approval.Paediatr. Drugs. 2021 Nov; 23: 609-613
- First therapy choice in newly diagnosed multiple sclerosis patients: a multicenter Italian study.Mult. Scler. Relat. Disord. 2020 Jul; 42102059
- Real world experience with teriflunomide in multiple sclerosis: the TER-Italy study.J. Neurol. 2021 Aug; 268: 2922-2932
- Influence of treatments in multiple sclerosis disability: a cohort study.Mult. Scler. 2015 Apr; 21: 433-441
- Meta- analysis of the age-dependent efficacy of multiple sclerosis treatments.Front. Neurol. 2017 Nov 10; 8: 577
- COVID-19 severity in multiple sclerosis: putting data into context.Neurol. Neuroimmunol. Neuroinflamm. 2021 Nov 9; 9e1105
- Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria.Lancet Neurol. 2018 Feb; 17: 162-173
- Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).Neurology. 1983; 33: 1444-1452
- “No evident disease activity”: the use of combined assessments in the management of patients with multiple sclerosis.Mult. Scler. 2017 Aug; 23: 1179-1187
- Defining the clinical course of multiple sclerosis: the 2013 revisions.Neurology. 2014; 83: 278-286
- Multiple sclerosis: assessment of disability and disability scales.J. Neurol. 1998; 245: 189-196
- Comparative effectiveness of delayed-release dimethyl fumarate versus interferon, glatiramer acetate, teriflunomide, or fingolimod: results from the German NeuroTransData registry.J. Neurol. 2018 Dec; 265: 2980-2992
- Lateral and escalation therapy in relapsing-remitting multiple sclerosis: a comparative study.J. Neurol. 2016 Sep; 263: 1802-1809
- Adherence to therapy in patients with multiple sclerosis-review.Int. J. Environ. Res. Public Health. 2022 Feb 15; 19: 2203
- Silent progression in disease activity-free relapsing multiple sclerosis.Ann. Neurol. 2019 May; 85: 653-666
- Smouldering multiple sclerosis: the ‘real MS’.Ther. Adv. Neurol. Disord. 2022 Jan 25; 15 (17562864211066751)
- Disease-modifying therapies and coronavirus disease 2019 severity in multiple sclerosis.Ann. Neurol. 2021 Apr; 89: 780-789
- COVID-19 in teriflunomide-treated patients with multiple sclerosis.J. Neurol. 2020; 267: 2790-2796
Akahata Y, Ngouth N, Ohayon J et al. Teriflunomide reduces spontaneous lymphoproliferation of peripheral blood mononuclear cells from patients with human t-lymphotropic virus (HTLV)-1-associated myelopathy/tropical spastic paraparesis. Presented at: 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). Berlin, Germany, 10–12 October 2018.
- Teriflunomide’s effect on humoral response to Epstein-Barr virus and development of cortical gray matter pathology in multiple sclerosis.Mult. Scler. Relat. Disord. 2019; 36101388
- (teriflunomide) [prescribing information]. Genzyme Corp, MA, USA.2019
- Family planning decision making in people with multiple sclerosis.Front. Neurol. 2021 Apr; 28620772
- Geographical variations in sex ratio trends over time in multiple sclerosis.PLoS One. 2012; 7e48078
Article info
Publication history
Published online: May 17, 2022
Accepted:
May 13,
2022
Received in revised form:
May 11,
2022
Received:
April 28,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
