Tagteriflunomide

Anti-CD20 vs. Teriflunomide

Barts-MS rose-tinted-odometer: ★★ (seeing blue) When I state that the real MS is smouldering MS and that relapses and focal MRI activity are not the disease I really mean it.  PwMS who are NEDA-2, without relapses and with no new MRI lesions, but getting worse must have something going on in their brains and spinal cords. This is why we need to go beyond NEIDA (no evidence of inflammatory...

Teriflunomide’s secrets

Barts-MS rose-tinted-odometer: ★★★★★ What should be our therapeutic target in MS?  Reducing relapses and MRI activity, NEDA (no evident disease activity) or saving the end-organ (brain volume loss)?  I have been pushing the for the latter, i.e. the most important treatment target must be protecting the end-organ and saving or protecting as many neurons, axons and synapses as possible in...

A false sense of security?

Just catching up with my reading. Whilst I was away on holiday the ASCLEPIOS I and II trials was published in the New England Journal of Medicine.  There is little doubt that ofatumumab is superior to teriflunomide when it comes to suppressing focal inflammation, i.e. relapses, MRI activity and peripheral blood neurofilament levels. However, ofatumumab’s effectiveness against teriflunomide on the...

#COVIDMS Coronavirus creates an opportunity for teriflunomide

Should I switch to teriflunomide?  Please don’t panic! The coronavirus or COVID-19 pandemic is a problem but needs a calm and considered public health approach, which is happening in the UK. At the moment the general public, including pwMS, are overreacting. Another patient emailed me yesterday to inform me they are going to stop their ocrelizumab and asked what the consequences will be. In the...

OVO Study

Finally, after a week or more of thinking and contemplation my opinion about the ofatumumab vs. teriflunomide trial data (ASCLEPIOS I and II); another of my ECTRIMS highlights.  The result of the ASCLEPIOS I and II are not unexpected and in line with the treatment effects of anti-CD20 therapies with some caveats.  Novartis summary: Both ASCLEPIOS I and II studies met their primary endpoints in...

Results time

It is time to set in stone our #CrowdThink competition results. We had over 110 responses; thank you. If you want to know more about the rationale behind this competition you need to read my post on the DODO trial and the post explaining the rationale behind the COMPETITION. Study 1: Oral Ponesimod Versus Teriflunomide In Relapsing MUltiple Sclerosis (OPTIMUM). The Crowd has predicted that...

DODO study

When you are fighting a war, even if it is only a marketing war, small effects can be the difference between winning and losing. The TENERE study below would indicate that teriflunomide has similar efficacy to interferon-beta-1a (Rebif). However, this study was underpowered to show a difference between these two DMTs. Based on this and other data I suspect teriflunomide is more effective than IFN...

Warts and all

I have previously made the case that warts, both cutaneous and genital, are a relative contraindication to alemtuzumab therapy. I had one patient who has a torrid time with cutaneous warts after receiving alemtuzumab treatment. Fortunately, her immune system rejected them when it reconstituted and she is now fine. At least with alemtuzumab and other IRTs (immune reconstitution therapies) you can...

DMF versus Teriflunomide

Treatment algorithm (Ingwersen J et al.) Did I hear you say injectables, what injectables? The turf war in the first-line RRMS treatments is clearly between the two oral therapies; dimethyl fumarate (DMF) and teriflunomide (Teri)!Each have their Achilles heel. DMF with its lymphopenia (drop in lymphocyte counts) and Teri with its transaminitis. So, it isn’t surprising that the weighing...

Real-world experience on first line oral therapies DMF and teriflunomide

Comparable efficacy and safety of dimethyl fumarate and teriflunomide treatment in Relapsing-Remitting Multiple Sclerosis: an Italian real-word multicenter experience E D’Amico, A Zanghì, G Callari, G Borriello, A Gallo, G Graziano, P Valentino, M Buccafusca, S Cottone, G Salemi, P Ragonese, R B Bossio, R Docimo, L M E Grimaldi, C Pozzilli, G Tedeschi, M Zappia, F Patti Ther Adv Neurol Disord...

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