Does Teriflunomide Bloom at Every Age?
What impact does age have on the effectiveness of multiple sclerosis (MS) therapy in real-world clinical practice? How do the outcomes differ for patients treated with teriflunomide considering their age and previous therapy? The authors of a study published this year in the journal Therapeutic Advances in Neurological Disorders focused on the efficacy and safety of teriflunomide in real-world clinical practice with regard to age and prior treatment.
Treating MS at Different Ages
Multiple sclerosis is a disease typically associated with younger patients, but the spectrum of sufferers is relatively broad. Therefore, more research focusing on the effectiveness and safety of individual disease-modifying drugs (DMDs) in the context of age is required. Over time, an increasing number of DMDs become available, and nearly every patient today tries several of them. What impact do these changes have?
Evaluating Real-World Data
The presented study specifically focused on teriflunomide, which is classified as a first-line DMD in MS therapy. An added value of this drug is that it is the only oral treatment in this line. Its therapeutic effect is based on reducing the number of lymphocytes.
A total of 1128 patients were included in the analysis using data from the German TAURUS-MS I registry. Of them, 558 (49.5%) were older than 45 years. A total of 593 had undergone treatment with another DMD in the previous 6 months. Older individuals had slightly higher baseline EDSS scores (Expanded Disability Status Scale), while the incidence of relapses was lower.
Results
During the first year of using teriflunomide, the annual relapse rate decreased in both groups: the group without previous DMD treatment (prior to teriflunomide: 0.82 ± 0.73 vs. 0.25 ± 0.55 one year after starting teriflunomide therapy) and the group with prior DMD treatment (0.48 ± 0.76 vs. 0.22 ± 0.50). During the 2-year follow-up of patients treated with teriflunomide, EDSS scores remained stable across age categories.
The occurrence of adverse events during teriflunomide use was highest in the age group > 55 years (38.9%) and lowest in the age group between 25 and 35 years (29.2%). In the higher age group, adverse events leading to discontinuation of treatment, such as diarrhea, alopecia, and nausea, were also more frequently reported. The incidence of adverse events was lower in patients who had previously used another drug from the DMD group before teriflunomide.
Conclusion
All monitored patients benefited from teriflunomide therapy in real-world clinical practice, regardless of age and prior treatment.
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Source: Kallmann B. A., Ries S., Kullmann J. S. et al. Teriflunomide in relapsing-remitting multiple sclerosis: outcomes by age and pre-treatment status. Ther Adv Neurol Disord 2021; 14: 17562864211005588, doi:10.1177/17562864211005588.
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