Open AccessMagnetic resonance imaging outcomes from a phase III trial of teriflunomide
Author(s) -
Jerry S. Wolinsky,
Ponnada A. Narayana,
Flavia Nelson,
Sushmita Datta,
Paul O’Connor,
Christian Confavreux,
Giancarlo Comi,
Ludwig Kappos,
Tomas Olsson,
Philippe Truffinet,
Lin Wang,
Aaron Miller,
Mark S. Freedman
Publication year - 2013
Publication title -
multiple sclerosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.729
H-Index - 131
eISSN - 1477-0970
pISSN - 1352-4585
DOI - 10.1177/1352458513475723
Subject(s) - teriflunomide , multiple sclerosis , medicine , magnetic resonance imaging , placebo , lesion , nuclear medicine , population , fingolimod , radiology , pathology , psychiatry , alternative medicine , environmental health
Objective: The purpose of this study was to determine the effects of oral teriflunomide on multiple sclerosis (MS) pathology inferred by magnetic resonance imaging (MRI).Methods: Patients ( n=1088) with relapsing MS were randomized to once-daily teriflunomide 7 mg or 14 mg, or placebo, for 108 weeks. MRI was recorded at baseline, 24, 48, 72 and 108 weeks. Annualized relapse rate and confirmed progression of disability (sustained ≥12 weeks) were the primary and key secondary outcomes. The principal MRI outcome was change in total lesion volume.Results: After 108 weeks, increase in total lesion volume was 67.4% ( p=0.0003) and 39.4% ( p=0.0317) lower in the 14 and 7 mg dose groups versus placebo. Other measures favoring teriflunomide were accumulated enhanced lesions, combined unique activity, T2-hyperintense and T1-hypointense component lesion volumes, white matter volume, and a composite MRI score; all were significant for teriflunomide 14 mg and most significant for 7 mg versus placebo.Conclusions: Teriflunomide provided benefits on brain MRI activity across multiple measures, with a dose effect evident on several markers. These effects were also consistent across selected subgroups of the study population. These findings complement clinical data showing significant teriflunomide-related reductions in relapse rate and disease progression, and demonstrate containment of MRI-defined disease progression.