PLoS ONE (Jan 2021)

Real-world outcomes for a complete nationwide cohort of more than 3200 teriflunomide-treated multiple sclerosis patients in The Danish Multiple Sclerosis Registry.

  • Viktoria Papp,
  • Mathias Due Buron,
  • Volkert Siersma,
  • Peter Vestergaard Rasmussen,
  • Zsolt Illes,
  • Matthias Kant,
  • Claudia Hilt,
  • Zsolt Mezei,
  • Homayoun Roshanisefat,
  • Tobias Sejbæk,
  • Arkadiusz Weglewski,
  • Janneke van Wingerden,
  • Svend Sparre Geertsen,
  • Stephan Bramow,
  • Finn Sellebjerg,
  • Melinda Magyari

DOI
https://doi.org/10.1371/journal.pone.0250820
Journal volume & issue
Vol. 16, no. 5
p. e0250820

Abstract

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ObjectiveTeriflunomide is a once-daily, oral disease-modifying therapy (DMT) for relapsing forms of multiple sclerosis (MS). We studied clinical outcomes in a real-world setting involving a population-based large cohort of unselected patients enrolled in The Danish Multiple Sclerosis Registry (DMSR) who started teriflunomide treatment between 2013-2019.MethodsThis was a complete nationwide population-based cohort study with prospectively enrolled unselected cases. Demographic and disease-specific patient parameters related to treatment history, efficacy outcomes, and discontinuation and switching rates among other clinical variables were assessed at baseline and during follow-up visits.ResultsA total of 3239 patients (65.4% female) started treatment with teriflunomide during the study period, 56% of whom were treatment-naïve. Compared to previously treated patients, treatment-naïve patients were older on average at disease onset, had a shorter disease duration, a lower Expanded Disability Status Scale score at teriflunomide treatment start and more frequently experienced a relapse in the 12 months prior to teriflunomide initiation. In the 3001 patients initiating teriflunomide treatment at least 12 months before the cut-off date, 72.7% were still on treatment one year after treatment start. Discontinuations in the first year were due mainly to adverse events (15.6%). Over the full follow-up period, 47.5% of patients discontinued teriflunomide treatment. Sixty-three percent of the patients treated with teriflunomide for 5 years were relapse-free, while significantly more treatment-naïve versus previously treated patients experienced a relapse during the follow-up (pConclusionsSolid efficacy and treatment persistence data consistent with other real-world studies were obtained over the treatment period. Treatment outcomes in this real-world scenario of the population-based cohort support previous findings that teriflunomide is an effective and generally well-tolerated DMT for relapsing MS patients with mild to moderate disease activity.