Teriflunomide treatment is associated with optic nerve recovery in early multiple sclerosis

Steffen Pfeuffer; Laura Kerschke; Tobias Ruck; Leoni Rolfes; Marc Pawlitzki; Philipp Albrecht; Heinz Wiendl; Sven G Meuth

doi:10.1177/1756286421997372

Teriflunomide treatment is associated with optic nerve recovery in early multiple sclerosis

Ther Adv Neurol Disord. 2021 Mar 6:14:1756286421997372. doi: 10.1177/1756286421997372. eCollection 2021.

Authors

Steffen Pfeuffer¹, Laura Kerschke², Tobias Ruck³, Leoni Rolfes⁴, Marc Pawlitzki⁴, Philipp Albrecht³, Heinz Wiendl⁴, Sven G Meuth³

Affiliations

¹ Department of Neurology and Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster, 48149, Germany.
² Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany.
³ Department of Neurology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
⁴ Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Muenster, Germany.

Abstract

Background and aims: Various attempts have been made to support recovery following optic neuritis (ON), but the respective trials have mostly been negative. The aim of this study was to determine whether disease-modifying treatment (DMT) following ON as first manifestation of relapsing-remitting multiple sclerosis influences long-term outcomes.

Methods: A total of 79 patients with ON were identified and evaluated at relapse, DMT induction, and 12 months following treatment induction with either glatiramer acetate (GLAT), interferon-beta (IFN), or teriflunomide (TRF). Low-contrast letter acuity (LCLA) and full-field visual-evoked potentials (FF-VEP) were compared between treatment groups using multivariable regression models. The impact of TRF treatment induction compared with IFN or GLAT following relapses outside the optic nerves was evaluated in an independent cohort of 122 patients. Magnetic resonance imaging (MRI) outcomes and rates of confirmed improvement of relapse-related disability were evaluated.

Results: TRF-treated patients exhibited higher LCLA and lower relative P100 latencies normalized to the fellow-eye. Findings were significant following covariate-adjustment by multivariable analyses. Cranial MRI lesion load as well as disability progression rates were not significantly different between groups. The cohort of patients following relapses other than ON showed no differences in confirmed improvement of disability.

Conclusion: TRF treatment is associated with favorable outcomes regarding functional optic nerve recovery following ON in early multiple sclerosis.

Keywords: disease-modifying treatment; multiple sclerosis; optic neuritis; teriflunomide.