Summary

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• This summary is based on the review of 12 systematic review(s)/meta-analysis(es). ^[1-12]
• Teriflunomide (TRF) significantly reduced brain volume loss in relapsing multiple sclerosis (RMS) patients at two years, with a mean difference (MD) of 0.38 compared to placebo (95% confidence interval (CI): 0.20 - 0.55).
• Over 24 months, teriflunomide likely achieved a moderate decrease in relapse rates in relapsing-remitting multiple sclerosis (RRMS) with a relative risk (RR) of 0.62 versus placebo (95% CI: 0.55 - 0.70), while no moderate- or high-certainty evidence was available for relapse reduction at 36 months.
• In real-world comparisons, dimethyl fumarate (DMF) showed a slight advantage over teriflunomide in short-term relapse reduction (relative risk (RR) = 0.92, p = 0.01) without significant differences in confirmed disability worsening (RR = 0.99, p = 0.69).
• Cladribine tablets were more effective than teriflunomide in achieving no evidence of disease activity (NEDA-3) with an odds ratio (OR) of 2.78 (95% credible interval (CrI): 1.60-4.83), although they were not more effective than fingolimod in this outcome.
• Teriflunomide may result in a slight increase in treatment discontinuation due to adverse events (OR 1.82, 95% CI 1.19 to 2.79), with no drug significantly reducing withdrawals due to adverse events compared to placebo.
• Moderate-certainty evidence suggests teriflunomide meets non-inferiority criteria for serious adverse events compared to placebo (RR 1.08, 95% CI 0.88 to 1.31).
• Long-term teriflunomide treatment demonstrated a low risk of lymphopenia and infections, with Grade 1 lymphopenia at 7.3% and Grade 2 lymphopenia at 2.2%.
• There is no population types or subgroups information available in the reviewed studies.