Comparison of 2-year Teriflunomide Outcomes between DMT-naive and switch patients with Relapsing MS: subanalysis of the Real-World TERICARE study
Jose Meca Lallana1, Jose María Prieto2, Ana Belén Caminero3, Javier Olascoaga4, Rosa Casademont Portell5, Mireia Forner5
1Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain, 2Complejo Hospitalario Universitario de Santiago de Compostela, Spain, 3Complejo Asistencial de Ávila, Spain, 4Hospital Universitario Donostia, Spain, 5Sanofi, Barcelona, Spain
Objective:
To evaluate the effect of teriflunomide on clinical and patient-reported outcomes (PROs) in disease-modifying therapy (DMT)-naive and previously treated (switch) patients with relapsing-remitting multiple sclerosis (RRMS).
Background:
Clinical trials and real-world evidence have shown that patients with RRMS benefit from teriflunomide regardless of prior exposure to DMT.
Design/Methods:
TERICARE was a multicentre, observational and prospective study in Spain. RRMS patients with no relapses within the last 30 days before the inclusion received teriflunomide for 2-years. This analysis compared the annualized relapse rate (ARR), Expanded Disability Status Scale (EDSS), disability worsening, quality of life (Multiple Sclerosis Impact Scale, MSIS-29), fatigue (Modified Fatigue Impact Scale-5), and depression (Beck Depression Inventory-II) between DMT-naive and switch patients.
Results:
Of 325 patients included, 117 were DMT-naive and 208 switch patients. At baseline, DMT-naive was younger than switch patients (40.9 vs 44.4 years; p=0.003), had shorter disease duration (3.1 vs 9.5 years; p<0.001), lower EDSS score (1.3 vs 2.0; p<0.001), higher number of relapses in the last 2 years (1.3 vs 0.6; p<0.001) and ARR (95% CI) (0.63 [0.53-0.74] vs 0.31 [0.26-0.37]; p<0.001). The ARR was significantly reduced in both groups after 12 months (DMT-naive=0.24; p<0.001; switch=0.21; p=0.032) and 24 months (DMT-naive=0.19; switch=0.16; p<0.001, both groups). A greater reduction of ARR was observed in DMT-naive both at 12 (63% vs 33%) and 24 months (70% vs 49%). Mean change in EDSS score did not vary between groups, nor the percentage of patients with disability worsening at 12 (20% vs 13.2%; p=0.167) and 24 months (24.2% vs 17.6%; p=0.246). DMT-naive experienced a greater and significant reduction (improvement) in psychological MSIS-29 score at month 24 compared to switch group (-7.11 vs -1.48; p=0.019).
Conclusions:
Teriflunomide shows effectiveness in both DMT-naive and switch RRMS patients with a trend towards better relapse and quality of life outcomes in DMT-naive.