Prognostic factors for disease activity in newly diagnosed teriflunomide-treated patients with multiple sclerosis: a nationwide Danish study.

BACKGROUND

Clinicians frequently rely on relapse counts, T2 MRI lesion load (T2L) and Expanded Disability Status Scale (EDSS) scores to guide treatment decisions for individuals diagnosed with multiple sclerosis (MS). This study evaluates how these factors, along with age and sex, influence prognosis during treatment with teriflunomide (TFL).

METHODS

We conducted a nationwide cohort study using data from the Danish Multiple Sclerosis Registry.Eligible participants had relapsing-remitting MS or clinically isolated syndrome and initiated TFL as their first treatment between 2013 and 2019. The effect of age, pretreatment relapses, T2L and EDSS scores on the risk of disease activity on TFL were stratified by sex.

RESULTS

In total, 784 individuals were included (57.4% females). A high number of pretreatment relapses (≥2) was associated with an increased risk of disease activity in females only (OR and (95% CI): 1.76 (1.11 to 2.81)). Age group 50+ was associated with a lower risk of disease activity in both sexes (OR females=0.28 (0.14 to 0.56); OR males=0.22 (0.09 to 0.55)), while age 35-49 showed a different impact in males and females (OR females=0.79 (0.50 to 1.23); OR males=0.42 (0.24 to 0.72)). EDSS scores and T2L did not show any consistent associations.

CONCLUSION

A high number of pretreatment relapses was only associated with an increased risk of disease activity in females, while age had a differential impact on the risk of disease activity according to sex. Clinicians may consider age, sex and relapses when deciding on TFL treatment.

Informations de copyright

© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: MRM has received support from Merck for participation in a scientific meeting. MM has served on scientific advisory boards, served as a consultant, received support for congress participation, or received speaker honoraria from Roche, Sanofi, Biogen, Merck, Novartis, Bristol Myers Squibb, Medscape, Alexion, and Moderna. Her research group has contracts with Biogen, Merck, Novartis, Roche, Sanofi, and Bristol Myers Squibb. FE has received speaker honoraria from Roche and Sanofi. RPH has received speaker honoraria from Sanofi and Novartis, has served on an advisory board for Novartis, and has received a travel grant from The Danish Multiple Sclerosis Society. AW has served on advisory boards for Merck, Sanofi, Roche, and Biogen. He has also received honoraria for lecturing and manuscript writing from Sanofi, Merck, and Roche and has received financial support for congress participation from Biogen, Sanofi, Novartis, Merck and Roche. MBP reports support for congress participation from Novartis and Merck. ZI has received speaker honoraria, been a member of an advisory board, and received support for congress participation from Sanofi. TS has received travel grants from Sanofi and Merck, research grants from Biogen, Merck and Roche, served on advisory boards for Biogen, Merck, Novartis and Sanofi, and received honoraria for lecturing from Biogen, Merck, Novartis and Sanofi. MLS has received support for congress participation from Biogen, Merck, and Roche and has participated on advisory boards for Sanofi and Roche. PVR has served on scientific advisory boards, received support for congress participation or received speaker honoraria from Biogen, Merck, Novartis, Roche and Sanofi. FS has served on scientific advisory boards, served as a consultant, received support for congress participation or received speaker honoraria from Biogen, Bristol Myers Squibb, H. Lundbeck A/S, Merck, Novartis, Roche and Sanofi. His laboratory has received research support from Biogen, Merck, Novartis, Roche and Sanofi. In addition, FS is section editor of the journal Multiple Sclerosis and Related Disorders, chairman of the research board for the Danish Multiple Sclerosis Society, and member of the scientific steering committee for the International Progressive MS Alliance.