WEDNESDAY, Oct. 5 (HealthDay News) -- A new oral drug for
relapsing forms of multiple sclerosis appears to reduce relapse
rates and disability progression, according to the results of a
so-called phase 3 trial.
The experimental drug, teriflunomide, is one of the few oral
drugs that treat this type of MS and may, if approved, be a good
choice for many MS patients, researchers said.
"Basically, these are very good results because not only was the drug effective, but it was also very safe," said lead researcher Dr. Paul O'Connor, director of the Multiple Sclerosis Clinic and MS Research at the University of Toronto in Canada.
The report was published in the Oct. 6 issue of the
New England Journal of Medicine. A phase 3 trial is done once it is known that a drug is safe and is usually the last step before U.S. Food and Drug Administration approval is sought.
For the study, O'Connor's team randomly assigned 1,088 patients,
ages 18 to 55, with relapsing/remitting multiple sclerosis to 7 or
14 milligrams of teriflunomide or a placebo once a day for more
than two years.
Over that time, patients taking teriflunomide saw a 31 percent
reduction in relapses with either dose of the drug, compared with
patients taking the placebo.
More than 27 percent of those receiving a placebo showed disease
progression, compared with 21.7 percent of those taking 7
milligrams of teriflunomide and 20.2 percent of those taking the 14
milligram dose, the researchers found. MRI scans confirmed the
differences.
The drug was basically well tolerated, but side effects -- such
as diarrhea, nausea, and hair thinning -- were more common among
teriflunomide patients than placebo patients. There were also
higher levels of an enzyme that can indicate liver damage in those
on the drug, the researchers noted.
The study was funded by Sanofi-Aventis, the maker of
teriflunomide. When or if the drug will be approved for sale is not
known, O'Connor said.
Most of the current MS drugs are injectables, and Timothy
Coetzee, a spokesman for the National Multiple Sclerosis Society,
said that "having an oral treatment option is always a good
thing."
"What I hear from people with MS is that they would prefer an oral treatment," Coetzee said.
However, treatment choice is also influenced by how long a drug
has been on the market. Some doctors and patients may prefer using
an older, proven treatment rather than a new drug that has not had
a lot of real-world testing, he said.
Another oral drug for multiple sclerosis, fingolimod (Gilenya),
approved by the FDA in 2010, appears to be more effective than
teriflunomide, but it has more serious side effects, Coetzee
said.
Dr. Kottil W. Rammohan, a professor of neurology at the
University of Miami Miller School of Medicine, said he thinks the
compliance rate will be better with an oral drug than with
shots.
"This drug (teriflunomide) is as effective as the shots," he said.
Another oral multiple sclerosis drug, BG-12, is also in phase 3
trials, with results similar to those for teriflunomide and it is
also well tolerated, Rammohan said.
"The landscape of MS treatment is becoming rosier by the minute," he added.
Dr. Moses Rodriguez, professor of neurology and immunology at
the Mayo Clinic in Rochester, Minn., said teriflunomide appears to
be relatively safe in contrast to other drugs for MS.
"I am impressed that there were not many serious infections, which makes this an attractive drug for MS patients," Rodriguez said.
But until the long-term consequences of taking teriflunomide are
known, Rodriguez said he suspects that most doctors will stick with
interferons for the first line of therapy. If those fail, he said,
teriflunomide would be used before the newly approved injectable
drug Tysabri, which has been linked with a serious brain
infection.
Multiple sclerosis is a disease of the nervous system that
affects the brain and spinal cord. It damages the myelin sheath,
which surrounds and protects nerve cells. MS symptoms can include
muscle weakness; balance and coordination problems; and thinking
and memory problems, according to the U.S. National Institutes of
Health.
More information
For more on multiple sclerosis, visit the
National Multiple Sclerosis Society.