Teriflunomide Use in Participants with Relapsing-Remitting MS Enrolled in the Narcoms Registry

Background: Teriflunomide is a once-daily oral immunomodulator approved for the treatment of relapsing forms of MS. The North American Research Committee on Multiple Sclerosis (NARCOMS) Registry is a voluntary self-report registry that collects longitudinal health-related information from people with MS.

Objectives: To describe demographic and clinical characteristics of NARCOMS participants with relapsing-remitting MS (RRMS) receiving teriflunomide, at initiation and after 1 year of teriflunomide treatment.

Methods: NARCOMS participants, with a reported diagnosis of RRMS who initiated teriflunomide and completed a follow-up survey 1 year later, were identified from data collected in semi-annual update surveys between April 2012 and April 2017. Demographic and clinical characteristics from treatment initiation and follow-up surveys were analyzed, including sex, age, and disability level as measured by the Patient-Determined Disease Steps (PDDS) scale, Performance Scales, and NARCOMS depression scale (DS). Descriptive statistics were used to summarize relevant characteristics.

Results: Out of 668 participants in the NARCOMS registry who ever received teriflunomide, 147 reported a diagnosis of RRMS, initiated teriflunomide and completed a follow-up survey 1 year later, and were therefore eligible for this analysis. Among them, 83.7% were female, 84.3% were white, and mean (SD) age at initiation was 46.3 (9.1) years, with a mean (SD) disease duration of 17.1 (8.8) years. At baseline, 91 participants (61.9%) reported no gait disability or early gait disability (PDDS ≤3); scores remained stable at follow-up in 90 (65.0%) participants, with 28 (19.0%) improving (data not available for n=7). Minimal to severe fatigue was reported at baseline by 122 (83.0%) participants; at follow-up, 77 (55.0%) participants reported no change in fatigue, 34 (24.3%) reported improvement, and 25 (17.9%) reported worsening fatigue. At initiation, 81 (57.4%) respondents reported minimal or greater depression, and at follow-up 108 (73.5%) had stable or improved DS scores. One or more corticosteroid-treated relapses were listed by 22 (15.0%) participants in the 12 months before initiating teriflunomide and by 29 (19.7%) in the following 12 months.

Conclusions: Demographic and clinical characteristics of the teriflunomide-treated cohort were similar to those of the overall RRMS population in the NARCOMS Registry. After 1 year of teriflunomide treatment, most respondents reported stability or improvement of disability, fatigue, and depression.