Fatigue in Multiple Sclerosis: What Can Teriflunomide Do?

Introduction

Fatigue is a difficult-to-grasp but important and frequent manifestation of multiple sclerosis. It significantly impacts the patient's quality of life. Slowing down or stopping the progression of fatigue is thus a crucial point in the treatment of multiple sclerosis. And how does teriflunomide stand in this area?

Methodology and Study Course

The prospective observational study Teri-FAST, based on data from real-world clinical practice in France, evaluated the effect of 14 mg teriflunomide per day on fatigue in patients with relapsing-remitting multiple sclerosis (RRMS). The level of fatigue was assessed using the French version of the Fatigue Impact Scale for Multiple Sclerosis (EMIF-SEP). The main evaluated parameter was the change in the EMIF-SEP scale after 2 years of teriflunomide treatment.

The authors also examined the potential impact on depression and quality of life, physical activity, and side effects of the therapy. The Beck Depression Inventory (BDI) was used to assess the degree of depression, and the Two-Life Scale TLS-QoL 10 was used to assess the quality of life. The level of physical activity was self-reported by the patients.

Results

210 patients were enrolled in the study (mean age 45.4 years). The average baseline score on the Kurtzke scale (EDSS − Expanded Disability Status Scale) was 1.76.

In approximately half of the patients (52.4%), teriflunomide was the first disease-modifying drug (DMD) used. The analysis included patients who had at least one follow-up during the study period. In these 163 individuals, the average change in EMIF-SEP after 2 years was −1.54 (95% confidence interval [CI] −4.02 to 0.94). Fatigue appeared to be stable in patients treated with teriflunomide over the observed period. Similarly, no significant changes were noted in the BDI and Two-Life Scale TLS-QoL 10 scales after 2 years. There was even a slight increase in self-reported physical activity. At the beginning of the study, 46% of patients were physically active, and after 2 years, this increased to 57%.

Compliance with treatment was high, and the safety profile corresponded to known and previously published results.

Conclusion

In RRMS patients treated with teriflunomide, the level of fatigue remained stable in real-world clinical practice after 2 years. Similarly, there was no worsening in the quality of life or increase in depression levels.

(dos)

Source: de Sèze J., Devy R., Planque E. et al. Fatigue in teriflunomide-treated patients with relapsing remitting multiple sclerosis in the real-world Teri-FAST study. Mult Scler Relat Disord 2021 Jan; 47: 102659, doi: 10.1016/j.msard.2020.102659.