Teriflunomide selectively and reversibly inhibits dihydro-orotate dehydrogenase (DHODH). DHODH is a mitochrondrial enzyme involved in pyrimidine synthesis required by rapidly dividing lymphocytes. As a result, teriflunomide exerts a cytostatic effect on stimulated lymphocytes in the periphery, thereby reducing their availability to migrate into the central nervous system.
This phase 3 trial compared teriflunomide (7 or 14mg) to subcutaneous interferon beta-1 (44µg) in 324 people with relapsing remitting MS. The primary endpoint was the first occurrence of a confirmed relapse or permanent treatment discontinuation for any cause.
The results showed no difference in time to failure or in annualised relapse between teriflunomide 14mg and IFNβ-1a 44µg. The annualised relapse rate was significantly higher with teriflunomide 7mg. The fatigue impact scale scores revealed more frequent fatigue with IFNβ-1a, but the differences were only significant with teriflunomide 7mg. In summary, there was no difference between teriflunomide 14mg and IFNβ-1a on annualised relapse rate. The relapse rate was actually higher with teriflunomide 7mg. Authors:
Vermersch P, Czlonkowska ASource:
Mult Scler. 2013 Oct 14. [Epub ahead of print]Read the abstract