Comparable Efficacy and Safety of Teriflunomide versus Dimethyl Fumarate for the Treatment of Relapsing-Remitting Multiple Sclerosis.

Published on Jul 15, 2021in Neurology Research International
· DOI :10.1155/2021/6679197
Nasim Nehzat6
Estimated H-index: 6
(Tehran University of Medical Sciences),
Omid Mirmosayyeb12
Estimated H-index: 12
(Tehran University of Medical Sciences)
+ 3 AuthorsVahid Shaygannejad25
Estimated H-index: 25
(IUMS: Isfahan University of Medical Sciences)
Sources
Abstract
Background. The aim of this observational study is to investigate the efficacy and safety of two approved oral disease-modifying therapies (DMTs) in patients with remitting-relapsing multiple sclerosis (RRMS): dimethyl fumarate (DMF) vs. teriflunomide (TRF). Methods. A total of 159 RRMS patients (82 on TRF and 77 on DMF) were included. The expanded disability status scale (EDSS), confirmed disability improvement (CDI), confirmed disability progression (CDP), and annualized relapse rate (ARR) were evaluated for the two-year period prior to enrollment in our study. The drug-associated adverse effects (AEs) were recorded. We conducted propensity matching score to compare the efficacy between TRF and DMF. Results. After matching for the confounders, TRF- and DMF-treated groups were not different in terms of EDSS ( null null null null null value = 0.54), CDI ( null null null null null value = 0.80), CDP ( null null null null null value = 0.39), and ARR ( null null null null null value >0.05). TRF discontinuation occurred in 2 patients (2.43%) due to mediastinitis and liver dysfunction, while a patient (1.29%) discontinued DMF due to depression. Incidence rate of AEs in the TRF-treated group was 81.4%: hair thinning (hair loss) (62.9%), nail loss (20.9%), and elevated aminotransferase (14.8%) were the most common AEs; in DMF-treated patients, AEs were 88.2% with predominance of flushing (73.2%), pruritus (16.9%), and abdominal pain (16.9%). Conclusion. Based on our findings, DMF is as efficacious and safe as TRF for the treatment of RRMS in our Iranian study population. Multicentric studies need to corroborate these findings in other populations.
References28
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#1Omid Mirmosayyeb (IUMS: Isfahan University of Medical Sciences)H-Index: 12
#2Serge Brand (University of Basel)H-Index: 62
Last. Dena Sadeghi Bahmani (Kermanshah University of Medical Sciences)H-Index: 15
view all 7 authors...
Background: Compared to the adult onset of multiple sclerosis (AOMS), both early-onset (EOMS) and late-onset (LOMS) are much less frequent, but are often under- or misdiagnosed. The aims of the present study were: 1. To compare demographic and clinical features of individuals with EOMS, AOMS and LOMS, and 2. To identify predictors for disability progression from relapsing remitting MS (RRMS) to secondary progressive MS (SPMS). Method: Data were taken from the Isfahan Hakim MS database. Cases wer...
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#1Tomas Kalincik (University of Melbourne)H-Index: 33
#2Sifat Sharmin (University of Melbourne)H-Index: 8
Last. Helmut Butzkueven (Monash University)H-Index: 64
view all 58 authors...
Objective: Whether immunotherapy improves long-term disability in multiple sclerosis has not been satisfactorily demonstrated. This study examined the effect of immunotherapy on long-term disability outcomes in relapsing-remitting multiple sclerosis. Methods: We studied patients from MSBase followed for 1 year, with 3 visits, 1 visit per year and exposed to a multiple sclerosis therapy, and a subset of patients with 15-year follow-up. Marginal structural models were used to compare the hazard of...
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#1David-Axel Laplaud (French Institute of Health and Medical Research)H-Index: 26
#2Romain Casey (University of Nantes)H-Index: 12
Last. Patrick VermerschH-Index: 70
view all 43 authors...
Objective In this study, we compared the effectiveness of teriflunomide (TRF) and dimethyl fumarate (DMF) on both clinical and MRI outcomes in patients followed prospectively in the Observatoire Francais de la Sclerose en Plaques. Methods A total of 1,770 patients with relapsing-remitting multiple sclerosis (RRMS) (713 on TRF and 1,057 on DMF) with an available baseline brain MRI were included in intention to treat. The 1- and 2-year postinitiation outcomes were relapses, increase of T2 lesions,...
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#1Tomas Kalincik (University of Melbourne)H-Index: 33
#2Eva Havrdova (First Faculty of Medicine, Charles University in Prague)H-Index: 73
Last. Helmut ButzkuevenH-Index: 64
view all 44 authors...
Objective Oral immunotherapies have become a standard treatment in relapsing-remitting multiple sclerosis. Direct comparison of their effect on relapse and disability is needed. Methods We identified all patients with relapsing-remitting multiple sclerosis treated with teriflunomide, dimethyl fumarate or fingolimod, with minimum 3-month treatment persistence and disability follow-up in the global MSBase cohort study. Patients were matched using propensity scores. Three pairwise analyses compared...
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#1Daniel Ontaneda (Cleveland Clinic)H-Index: 23
#2Jacqueline Nicholas (OhioHealth)H-Index: 7
Last. Mehul Jhaveri (Biogen Idec)H-Index: 4
view all 10 authors...
Abstract Background Previous real-world comparative research of MS disease modifying therapies (DMTs) in the overall population has suggested dimethyl fumarate (DMF) to be comparable to fingolimod (FTY) and more efficacious than teriflunomide (TERI) in reducing relapses. However, there is limited comparative evidence in patients switching from platform DMTs in the US. The objective of the study was to compare the annualized relapse rate (ARR) and risk of relapse in MS patients who have switched ...
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#1Stefan BrauneH-Index: 6
#2Sarah GrimmH-Index: 1
Last. Arnfin BergmannH-Index: 7
view all 7 authors...
Background Comparative effectiveness (CE) research allows real-world treatment comparisons using outcome measurements important to physicians/patients. This German NeuroTransData registry-based analysis compared delayed-release dimethyl fumarate (DMF) effectiveness with interferons (IFN), glatiramer acetate (GA), teriflunomide (TERI), or fingolimod (FTY) in patients with relapsing–remitting multiple sclerosis (RRMS) using propensity score matching (PSM).
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#1Emanuele D’Amico (University of Catania)H-Index: 18
#2Aurora Zanghì (University of Catania)H-Index: 10
Last. Francesco PattiH-Index: 60
view all 18 authors...
Background:The aim of the study was to evaluate the achievement of ‘no evidence of disease activity’ (NEDA) over a 12-month period in a large multicenter population with relapsing remitting multipl...
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#1Eva Rosa PetersenH-Index: 7
#2Annette Bang OturaiH-Index: 36
Last. Helle Bach SøndergaardH-Index: 18
view all 7 authors...
Objective To investigate whether smoking in patients with relapsing-remitting multiple sclerosis (RRMS) treated with interferon beta (IFN-β) is associated with the relapse rate and whether there is an interaction between smoking and human leukocyte antigen (HLA)–DRB1*15:01, HLA-A*02:01, and the N-acetyltransferase-1 ( NAT1 ) variant rs7388368A. Methods DNA from 834 IFN-β–treated patients with RRMS from the Danish Multiple Sclerosis Biobank was extracted for genotyping. Information about relapses...
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#1Alan J. Thompson (UCL: University College London)H-Index: 146
#2Brenda Banwell (Children's Hospital of Philadelphia)H-Index: 71
Last. Jeffrey A. Cohen (Cleveland Clinic)H-Index: 41
view all 30 authors...
Summary The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated...
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#1Luca Mancinelli (UNIBO: University of Bologna)H-Index: 3
#2Paolo AmerioH-Index: 29
Last. Alessandra Lugaresi (UNIBO: University of Bologna)H-Index: 60
view all 7 authors...
Abstract Nail loss might represent a new, reversible, adverse event associated with teriflunomide treatment. It shares close analogies with hair loss and thinning, known adverse events of teriflunomide. MS specialists should be aware of this possibility and evaluate treatment discontinuation.
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