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Teriflunomide: A Review in Relapsing–Remitting Multiple Sclerosis

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Abstract

Teriflunomide (Aubagio®) is a disease-modifying immunomodulatory drug with anti-inflammatory properties that selectively and reversibly inhibits the mitochondrial enzyme dihydro-orotate dehydrogenase, with consequent inhibition of de novo pyrimidine synthesis and reduced lymphocyte proliferation. Based on extensive evidence from randomized controlled trials (RCTs) and the real-world setting, oral teriflunomide is an effective and generally well tolerated treatment in patients with relapsing multiple sclerosis (MS), with these benefits maintained during long-term treatment (≥ 10 years) and no new safety signals identified. In pivotal RCTs in this patient population, teriflunomide provided significantly better efficacy than placebo (TEMSO and TOWER) and was as effective as interferon β-1a (TENERE) in terms of improvements in clinical outcomes (such as reduced annualized relapse rates, prevention of disability progression) and/or MRI-assessed disease activity measures. Albeit head-to-head trials would definitively establish the relative efficacy of oral disease-modifying therapies, given its convenient oral regimen and beneficial effects in reducing relapses and disease activity, teriflunomide remains an effective option for the management of relapsing–remitting MS (RRMS).

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Acknowledgements

During the peer review process, the manufacturer of teriflunomide was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Lesley J. Scott

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Correspondence to Lesley J. Scott.

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The preparation of this review was not supported by any external funding.

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Lesley Scott is a salaried employee of Adis International Ltd./Springer Nature, is responsible for the article content and declares no relevant conflicts of interest.

Additional information

The manuscript was reviewed by:E. Bernitsas, Department of Neurology, Wayne State University, Detroit, MI, USA; S. de Biase, Neurology Unit, Department of Experimental and Clinical Medical Sciences, University of Udine Medical School, Udine, Italy; F. Ladeira, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.

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Scott, L.J. Teriflunomide: A Review in Relapsing–Remitting Multiple Sclerosis. Drugs 79, 875–886 (2019). https://doi.org/10.1007/s40265-019-01135-8

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