Author Of 1 Presentation
P0143 - Real-World Experience in RRMS and SPMS Patients with Higher Disability and Substantial Lymphopenia Switching from Prior DMTs to Teriflunomide (ID 1818)
Abstract
Background
Teriflunomide is a once-daily oral immunomodulator approved for the treatment of relapsing forms of multiple sclerosis (MS).
Objectives
To describe the patient characteristics and examine the effectiveness and safety of teriflunomide in patients who switched from other disease modifying therapies (DMTs).
Methods
A retrospective, observational, cohort study was conducted using medical charts on patients ≥ 18 years of age with diagnosis of RRMS or SPMS, who switched to teriflunomide from a prior DMT at a single MS center in the US. Data were extracted at 12 months prior (M-12), at baseline (M0), at 12 months post (M12), and at 24 months post (M24) initiating teriflunomide. Descriptive statistics were conducted for all outcome measures, including relapses, disability, MRI, and cognitive assessment.
Results
Eighty patients (60% RRMS, 40% SPMS) were included in this analysis with a mean age of 44.0 ± 14.55, disease duration of 9.35 ± 6.37 years, baseline EDSS of 3.88 ± 1.76, and 30% with lymphopenia (ALC < 1000/mm3). The most common prior DMTs were dimethyl fumarate (22.5%), glatiramer acetate (18.8%), and natalizumab (16.3%). Mean number of relapses were reduced from 0.26 ±0.44 in the year prior to study entry to 0.18± 0.38 (M12) and 0.05 ± 0.22 (M24). Over the 24 months, mean (95% confidence interval) number of relapses decreased by -0.21 (-0.32, -0.11; P<0.0001), representing an 80.8% reduction. MRI was stable or improved in more patients at M12 (95.1%) and at M24 (97.6%), compared to baseline (92.5%). Mean EDSS score, Montreal Cognitive Assessment (MoCA) test score, and timed 25-foot walk (T25FW) remained stable throughout the study. The percent of patients with lymphopenia was reduced from 30.0% (M0) to 6.3% (M12) and 1.3% (M24). No unexpected or serious AEs were reported.
Conclusions
his real-world study evaluated a more challenging MS cohort with higher EDSS, including a substantial proportion with SPMS, and comorbidities including lymphopenia. Patients who switched to teriflunomide from a prior DMT demonstrated a significant decrease in relapses, and MRI was stable or improved in more patients after initiating teriflunomide compared to baseline. Mean EDSS, T25FW, and MoCA remained stable. In patients previously treated with other DMTs, the proportion of patients with lymphopenia substantially decreased with teriflunomide.