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. 2021 Mar 6:14:1756286421997372.
doi: 10.1177/1756286421997372. eCollection 2021.

Teriflunomide treatment is associated with optic nerve recovery in early multiple sclerosis

Steffen Pfeuffer  1 , Laura Kerschke  2 , Tobias Ruck  3 , Leoni Rolfes  4 , Marc Pawlitzki  4 , Philipp Albrecht  3 , Heinz Wiendl  4 , Sven G Meuth  3
Affiliations

Teriflunomide treatment is associated with optic nerve recovery in early multiple sclerosis

Steffen Pfeuffer et al. Ther Adv Neurol Disord. .

Abstract

Background and aims: Various attempts have been made to support recovery following optic neuritis (ON), but the respective trials have mostly been negative. The aim of this study was to determine whether disease-modifying treatment (DMT) following ON as first manifestation of relapsing-remitting multiple sclerosis influences long-term outcomes.

Methods: A total of 79 patients with ON were identified and evaluated at relapse, DMT induction, and 12 months following treatment induction with either glatiramer acetate (GLAT), interferon-beta (IFN), or teriflunomide (TRF). Low-contrast letter acuity (LCLA) and full-field visual-evoked potentials (FF-VEP) were compared between treatment groups using multivariable regression models. The impact of TRF treatment induction compared with IFN or GLAT following relapses outside the optic nerves was evaluated in an independent cohort of 122 patients. Magnetic resonance imaging (MRI) outcomes and rates of confirmed improvement of relapse-related disability were evaluated.

Results: TRF-treated patients exhibited higher LCLA and lower relative P100 latencies normalized to the fellow-eye. Findings were significant following covariate-adjustment by multivariable analyses. Cranial MRI lesion load as well as disability progression rates were not significantly different between groups. The cohort of patients following relapses other than ON showed no differences in confirmed improvement of disability.

Conclusion: TRF treatment is associated with favorable outcomes regarding functional optic nerve recovery following ON in early multiple sclerosis.

Keywords: disease-modifying treatment; multiple sclerosis; optic neuritis; teriflunomide.

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Conflict of interest statement

Conflict of interest statement: Steffen Pfeuffer: received travel grants from Sanofi Genzyme and Merck Serono, lecturing honoraria from Sanofi Genzyme, Mylan Healthcare, and Biogen, and research support from Diamed, Merck Serono, and the German Multiple Sclerosis Society Northrhine-Westphalia. Laura Kerschke: declares no conflicts of interest Tobias Ruck: received travel grants and financial research support from Genzyme and Novartis and received honoraria for lecturing from Roche, Merck, Genzyme, Biogen, and Teva. Leoni Rolfes: received travel grants from Merck Serono and Sanofi-Genzyme. Marc Pawlitzki: received speaker honoraria and travel reimbursements from Novartis. Philipp Albrecht: received compensation for serving on Scientific Advisory Boards for Allergan, Biogen, Celgene, Ipsen, Merck Serono, Merz Pharmaceuticals, Novartis, and Roche. He received speaker honoraria and travel support from Allergan, Bayer Vital GmbH, Biogen, Celgene, Ipsen, Merck Serono, Merz Pharmaceuticals, Novartis, Roche. Philipp Albrecht received research support from Allergan, Biogen, Celgene, Ipsen, Merck Serono, Merz Pharmaceuticals, Novartis, and Roche. Heinz Wiendl: received compensation for serving on Scientific Advisory Boards/Steering Committees for Bayer Healthcare, Biogen Idec, Sanofi Genzyme, Merck Serono, and Novartis. He received speaker honoraria and travel support from Bayer Vital GmbH, Bayer Schering AG, Biogen, CSL Behring, EMD Serono, Fresenius Medical Care, Genzyme, Merck Serono, Omniamed, Novartis, and Sanofi Aventis. He received compensation as a consultant from Biogen Idec, Merck Serono, Novartis, Roche, and Sanofi-Genzyme. Heinz Wiendl also received research support from Bayer Healthcare, Bayer Vital, Biogen Idec, Merck Serono, Novartis, Sanofi Genzyme, Sanofi US, and Teva. Sven G. Meuth: received honoraria for lecturing and travel expenses for attending meetings from Almirall, Amicus Therapeutics Germany, Bayer Health Care, Biogen, Celgene, Diamed, Genzyme, MedDay Pharmaceuticals, Merck Serono, Novartis, Novo Nordisk, ONO Pharma, Roche, Sanofi-Aventis, Chugai Pharma, QuintilesIMS, and Teva. His research is funded by the German Ministry for Education and Research (BMBF), Deutsche Forschungsgemeinschaft (DFG), Else Kröner Fresenius Foundation, German Academic Exchange Service, Hertie Foundation, Interdisciplinary Center for Clinical Studies (IZKF) Muenster, German Foundation Neurology and by Almirall, Amicus Therapeutics Germany, Biogen, Diamed, Fresenius Medical Care, Genzyme, Merck Serono, Novartis, ONO Pharma, Roche, and Teva. The current work was conducted outside of third-party funding.

Figures

Figure 1.
Figure 1.
Optic nerve function parameters at relapse, DMT induction, and follow up (month 12). (a) LCLA. (b) P100 latency of the affected eye at relapse and follow-up normalized to values obtained from fellow eye at baseline. Error bars indicate the 95% CIs of means (horizontal line). CI, confidence interval; DMT, disease-modifying treatment; GLAT, glatiramer acetate; IFN, interferon-beta; LCLA, low-contrast letter acuity; TRF, teriflunomide.
Figure 2.
Figure 2.
MRI outcomes and disability burden at relapse and follow up (month 12). (a) EDSS scores at relapse and follow up. (b) T2-hyperintense MRI lesions at relapse and follow up. Error bars indicate the 95% CIs of means (horizontal line). CI, confidence interval; EDSS, expanded disability status scale; GLAT, glatiramer acetate; IFN, interferon-beta; MRI, magnetic resonance imaging; TRF, teriflunomide.
See this image and copyright information in PMC

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