Teriflunomide for the treatment of relapsing–remitting multiple sclerosis: patient preference and adherence

Figures & data

Table 1 Treatment options for RR MS (in alphabetical order)

Treatment	Dosing frequency
Infusions
Alemtuzumab (Lemtrada^®; Genzyme Therapeutics Ltd, Oxford, UK)	12 mg; first year: 5 infusions on consecutive days; second year: 3 infusions on consecutive days
Mitoxantrone (Ralenova^®; MEDA Pharma GmbH & Co. KG, Bad Homburg, Germany)	12 mg/m^2 body surface every 3 months (maximal cumulative dose 140 mg/m^2)
Natalizumab (Tysabri^®; Biogen Idec Limited, Maidenhead, Berkshire, UK)	300 mg every 4 weeks
Injectables
Glatiramer acetate sc (Copaxone^®; TEVA Pharmaceuticals USA, Inc., North Wales, PA, USA)	Once daily (20 mg) or tiw (40 mg)*
Interferon beta-1a im (Avonex^®; Biogen Idec Limited)	Weekly 30 μg
Interferon beta-1a sc (Rebif^®; Merck Serono Europe Limited, London, UK)	tiw 22 or 44 μg
Interferon beta-1a sc (Plegridy^®; Biogen Idec Limited)	Every 2 weeks 125 μg
Interferon beta-1b sc (Betaferon^®; Bayer AG, Leverkusen, Germany; and Extavia^®; Novartis Europharm Limited, West Sussex, UK)	Every other day 250 μg
Oral
Dimethyl fumarate (Tecfidera^®; Biogen Idec Limited)	bid 240 mg
Fingolimod (Gilenya^®; Novartis Europharm Limited, West Sussex, UK)	Once daily 0.5 mg
Teriflunomide (Aubagio^®; Sanofi-Aventis, Paris, France)	Once daily 7 mg or 14 mg*

Note:

* Approval and dosing dependent on national regulations.

Abbreviations: bid, twice daily; im, intramuscular; MS, multiple sclerosis; RR, relapsing–remitting; sc, subcutaneous; tiw, three times weekly.

Figure 1 Treatment satisfaction at week 48 was significantly improved with teriflunomide 14 mg compared with sc IFNβ-1a in the TSQM domains of global satisfaction, side-effects, and convenience.

Notes: *Least square mean values. Mixed-effect model with repeated measures adjusted for Expanded Disability Status Scale strata, region, visit, and treatment-by-visit interaction.⁶
Abbreviations: IFN, interferon; TSQM, Treatment Satisfaction Questionnaire for Medication.

Figure 2 Safety monitoring guidelines for teriflunomide.

Abbreviations: ALT, alanine aminotransferase; SGPT, serum glutamic pyruvic transaminase.

Table 2 Teriflunomide: factors potentially influencing patient preference in MS

Efficacy	Comparable to interferon beta-1a sc tiw in the TENERE study^Citation6
Route of administration	Oral
Dosing frequency	Once daily
Half-life	19 days (median)
Pharmacovigilance	Initially frequent liver enzyme controls (every 2 weeks)
Side effects (selection only)	Arterial hypertension Gastrointestinal disorders (diarrhea, nausea) Hair thinning Hematological abnormalities (leucopenia, lymphopenia) Liver enzyme increase

Abbreviations: MS, multiple sclerosis; sc, subcutaneous; TENERE, TErifluNomidE and REbif.^®; tiw, three times weekly.

VermerschPCzlonkowskaAGrimaldiLMTeriflunomide versus subcutaneous interferon beta-1a in patients with relapsing multiple sclerosis: a randomised, controlled phase 3 trialMultiple Sclerosis201420670571624126064

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