teriflunomide / Generic mfg. - LARVOL DELTA

IDENTIFYING MEANINGFUL PATIENT SAVINGS ON GENERICS: DIRECT-TO-CONSUMER PRICES VS COMMERCIAL INSURANCE (ISPOR 2026) - "DTC pharmacies such as MCCPDC meaningfully lower out-of-pocket costs for higher-cost generic prescriptions which could otherwise be difficult to afford. Commercially insured patients should consider DTC pharmacies when their copayment or coinsurance for a generic medication exceeds $15, and particularly when it exceeds $100."

Clinical • Reimbursement • US reimbursement • CNS Disorders • Depression • Endocrine Disorders • Erectile Dysfunction • Multiple Sclerosis

Pyrimidine Metabolism Drives Cystic Fibrosis Lung Disease (NACFC 2026) - "DNPPS was inhibited using siRNA targeting DHODH (DNPPS rate-limiting enzyme) and pharmacological inhibitors (leflunomide, teriflunomide, brequinar, and gemcitabine). CFTR correction was achieved using elexacaftor/tezacaftor/ivacaftor (ETI)... We show that airway remodeling and P. aeruginosa infection in the CF lung are tightly linked via altered pyrimidine signaling, a metabolic configuration promoted by CFTR mutations and mitochondrial impairment. We also reveal that this adverse environment is correctable, opening new therapeutic targets to improve CF patients' health."

Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Pulmonary Disease • Respiratory Diseases • CFTR

Predictors of high- versus low-intensity first-line multiple sclerosis treatments. (PubMed, Mult Scler J Exp Transl Clin) - "The first DMT filled was classified as either high- (natalizumab, alemtuzumab, ocrelizumab, rituximab, ofatumumab, cladribine) or low-intensity (interferon, glatiramer acetate, teriflunomide, dimethyl fumarate, diroximel fumarate, fingolimod, ponesimod, siponimod, ozanimod)...The minority of MS patients initiated high-intensity treatment although this proportion increased over time, and later years were predictive of high-intensity treatment. Providers had a significant role in the approach selected."

Journal • CNS Disorders • Multiple Sclerosis

Disease-modifying therapy uptake in a pediatric-onset multiple sclerosis population, British Columbia, Canada. (PubMed, J Neuroimmunol) - "Moderate-efficacy therapies were the more common initial DMT dispensed for individuals with POMS, but more than two-thirds eventually received a high-efficacy therapy. Only a minority of POMS cases were first dispensed a DMT under age 18 years."

Journal • CNS Disorders • Multiple Sclerosis • Pediatrics

Safety and efficacy of anti-CD20 monoclonal antibodies versus teriflunomide in relapsing multiple sclerosis: a systematic review and meta-analysis. (PubMed, Acta Neurol Belg) - "Anti-CD20 therapies provide effective control of relapse and MRI disease activity compared with teriflunomide in RMS. However, no clear advantage over teriflunomide was observed in reducing brain volume loss, and findings regarding disability progression were inconsistent. The modestly increased risk of serious adverse events highlight the need of large scale RCTs, individualized treatment decisions, and long-term safety monitoring."

Journal • Retrospective data • CNS Disorders • Infectious Disease • Multiple Sclerosis

Immunomodulatory and anti-inflammatory potential of S-nitrosoglutathione (GSNO) in multiple sclerosis: a review of mechanisms and therapeutic perspectives. (PubMed, Front Immunol) - "In contrast, small-molecule DMTs such as fingolimod and teriflunomide provide greater dosing convenience and flexibility; however, their broad immunosuppressive effects often lead to treatment-induced lymphopenia and increased susceptibility to infections. Building on this evidence, this review examines the GSNO/GSNOR axis as an emerging therapeutic target in MS, highlighting its mechanistic roles in selective immune modulation, the regulation of neuroinflammation, and the attenuation of oxidative stress. Furthermore, we discuss the translational potential of reversible GSNOR inhibitors, which have demonstrated favorable safety and tolerability in Phase I/II studies for asthma and cystic fibrosis, while emphasizing the need for future clinical evaluation of their therapeutic efficacy in MS."

Journal • Review • Asthma • CNS Disorders • Cystic Fibrosis • Genetic Disorders • Immune Modulation • Immunology • Infectious Disease • Inflammation • Multiple Sclerosis • Pulmonary Disease • Respiratory Diseases • HIF1A • IL6

Progression-related outcomes of teriflunomide in multiple sclerosis clinical trials. (PubMed, Front Neurol) - "Teriflunomide is emerging as a valuable, multi-faceted contributor to the MS treatment landscape, with data supporting its role in preserving brain volume, slowing disability progression, and maintaining cognitive function. Additionally, its favorable long-term tolerability and minimal immunocompromise effects further support its value as a therapeutic option over the longer course in PwMS."

Journal • Review • CNS Disorders • Cognitive Disorders • Inflammation • Multiple Sclerosis

FGF23-Mediated Hypophosphatemia Associated with Teriflunomide Therapy: A Case Report (ASBMR 2026) - No abstract available

Case report • Clinical • Late-breaking abstract • Renal Disease • FGF23

Comparative multi-analyte serum protein differences between generic and brand-name dimethyl fumarate, fingolimod, and teriflunomide in multiple sclerosis. (PubMed, Clin Immunol) - "We compared biomarker variability in MS individuals (n = 1124) treated with generic or brand-name fumarates (diroximel fumarate, dimethyl fumarate (DMF)), fingolimod, and teriflunomide...Additionally, all generic DMTs demonstrated higher multi-variable variability index values across 18 proteins associated with MS disease activity. Greater biomarker variability with generic formulations may reflect differences in therapeutic exposure and less consistent disease control."

Journal • CNS Disorders • Multiple Sclerosis • CCL20 • CXCL13 • CXCL9 • TNFSF13B

Heterogeneity in Teriflunomide Treatment Arms: A Systematic Review and Meta‑Regression of Randomised Multiple Sclerosis Trials. (PubMed, CNS Drugs) - "Teriflunomide-treated trial populations have shifted toward lower relapse activity over time, and trial start year was the principal predictor of between-trial heterogeneity in ARR in exploratory analyses. These findings most plausibly reflect evolving recruitment and diagnostic practices rather than changes in drug efficacy. Accounting for these temporal dynamics is essential when interpreting outcomes from RMS trial using teriflunomide as comparator."

Heterogeneity • Journal • Review • CNS Disorders • Multiple Sclerosis

What is the evidence on immunomodulators and immunosuppressants for relapsing-remitting multiple sclerosis? - A Cochrane Review summary with commentary. (PubMed, NeuroRehabilitation) - "High-certainty evidence suggests that natalizumab largely reduces relapses at 12 (RR 0.52, 95% CI 0.43 to 0.63) and 24 months (RR 0.56, 95% CI 0.48 to 0.65), and cladribine (RR 0.53, 95% CI 0.44 to 0.64) and alemtuzumab (RR 0.57, 95% CI 0.47 to 0.68) largely reduce relapses at 24 months. People taking fingolimod, teriflunomide, glatiramer acetate, interferon beta-1a, laquinimod, natalizumab and daclizumab are more likely to discontinue the drug because of unwanted effects. Lack of data for treatment effects beyond two years and poor reporting of adverse events in short-term trials limit the applicability of these findings."

Journal • Review • CNS Disorders • Multiple Sclerosis

Immunometabolic reprogramming in multiple sclerosis: from pathogenic amplifier to therapeutic target in neuroinflammation and remyelination. (PubMed, Inflammopharmacology) - "Established multiple sclerosis therapies, dimethyl fumarate and teriflunomide, exhibit direct, previously unrecognized metabolic effects, validating this pathway as therapeutically viable. Emerging strategies intentionally target these vulnerabilities: glutaminase inhibitors to counteract pathogenic Th17 cells, AMPK activators such as metformin to enhance remyelination, mTOR inhibitors to restore immune tolerance, and NAD + precursors to rejuvenate mitochondrial function. Transitioning from broad immunosuppression to specific metabolic reprogramming offers remarkable opportunities for tackling chronic neuroinflammation and correcting remyelination deficits in progressive multiple sclerosis. Immuno-metabolic pharmacology is a promising field; however, its clinical application necessitates stringent validation via meticulously designed trials and dependable biomarkers."

IO biomarker • Journal • Review • CNS Disorders • Epstein-Barr Virus Infections • Immunology • Infectious Disease • Inflammation • Metabolic Disorders • Multiple Sclerosis • HIF1A

Clinical Efficacy and Brain Volumetric Changes in Pediatric-Onset Multiple Sclerosis Under Teriflunomide Treatment. (PubMed, J Child Neurol) - "These findings provide exploratory evidence of longitudinal volumetric change in a teriflunomide-treated POMS cohort despite residual clinical disease activity. Given the limitations of the study design, including the absence of a control group, these results should be interpreted cautiously and warrant confirmation in larger, controlled longitudinal studies."

Journal • CNS Disorders • Multiple Sclerosis • Pediatrics

Teriflunomide Slows Osteoarthritis Progression via Wnt/β-Catenin and NLRP3 Pyroptosis Pathways. (PubMed, Tissue Eng Part A) - "Collectively, these findings suggest that TFM exerts chondroprotective effects in preclinical models by reactivating Wnt/β-catenin signaling and inhibiting NLRP3-dependent pyroptosis. TFM warrants further investigation as a potential candidate agent for the treatment of patients with OA."

Journal • Immunology • Osteoarthritis • Pain • Rheumatology • CCND1 • IL1B • MYC • NLRP3

Treatment Specific Infection Risk in Multiple Sclerosis Patients - a Danish Nationwide Registry Study (EAN 2026) - "All DMTs, especially anti-CD20 agents (HR: 3.0, 95% CI: 2.7–3.5), were associated with higher infection risks than teriflunomide, except alemtuzumab...Alemtuzumab and ocrelizumab raised antimycotic use, and alemtuzumab had the highest total AM use. This nationwide registry study found that anti-CD20 DMTs conferred the highest infection risk, while alemtuzumab was associated with the greatest AM use. These findings underscore the heterogeneity of infection profiles and emphasize the need for tailored clinical management strategies across DMTs."

Clinical • CNS Disorders • Infectious Disease • Multiple Sclerosis

Comparative Efficacy and Safety of Disease-Modifying Therapies in Pediatric Relapsing-Remitting Multiple Sclerosis: A Network Meta-Analysis (EAN 2026) - "Available treatments include interferon beta-1a, glatiramer acetate (GA), fingolimod, dimethyl fumarate (DMF), and teriflunomide, but comprehensive comparisons of disease-modifying therapies (DMTs) remain limited...Rituximab produced the largest ARR reduction (-1.12), followed by GA (-1.02) and natalizumab (−1.01), while ocrelizumab, DMF, and fingolimod also showed significant ARR reductions; interferon beta and teriflunomide were non-significant... Rituximab was the most effective therapy for reducing relapse rates in pediatric and young MS patients, with additional MRI, relapse-free, and disability benefits observed across agents and variable safety profiles."

Retrospective data • CNS Disorders • Multiple Sclerosis • Pediatrics • Rare Diseases

Real-world pharmacovigilance analysis of the association between multiple sclerosis disease-modifying therapies and intervertebral disc herniation. (PubMed, Front Pharmacol) - " Teriflunomide, natalizumab and ocrelizumab have shown positive disproportionality signals for intervertebral disc herniation. Three medications demonstrated positive disproportionality reporting signals for intervertebral disc herniation, which require further validation. Clinicians are suggested to raise vigilance on spinal adverse events and tailor therapeutic strategies when prescribing these agents for multiple sclerosis management."

Adverse events • Journal • Real-world evidence • CNS Disorders • Multiple Sclerosis

West Nile Neuroinvasive Disease: Current Management, Emerging Therapies and Future Clinical Trial Priorities. (PubMed, Rev Med Virol) - "Corticosteroids show no significant survival benefit, and ribavirin is discouraged due to potential toxicity and lack of in vivo efficacy...More recently, remdesivir and repurposed drugs like nitazoxanide and teriflunomide have emerged as potential candidates, though they require validation through controlled trials. Future therapeutic success likely depends on early intervention (within 7-10 days of symptom onset) and multitargeted combination approaches that address viral replication, immune modulation, and neuroprotection. There is an urgent need for adequately powered clinical trials and the acceleration of human vaccine development to mitigate the impact of this expanding public health threat."

Journal • Review • Immune Modulation • Immunology • Infectious Disease

T-cell receptor excision circles and Kappa-deleting recombination excision circles as biomarkers of immune aging in multiple sclerosis (EAN 2026) - "DMTs had distinct effects on immune output: TRECs significantly decreased under fingolimod, remained stable with alemtuzumab and cladribine, and increased with other therapies at 1 year. KRECs declined markedly under fingolimod and anti-CD20 therapies, more mildly under dimethyl fumarate and teriflunomide, and increased under natalizumab... TRECs and KRECs primarily reflect immune ageing in MS and are differentially modulated by DMTs. This study prompts future investigations for their role as markers of DMT response."

Biomarker • IO biomarker • CNS Disorders • Multiple Sclerosis

Relapse activity after ponesimod discontinuation in the OPTIMUM long-term extension study. (EAN 2026) - "Background and aims: OPTIMUM was a 2-year phase 3 trial comparing ponesimod versus teriflunomide in relapsing multiple sclerosis. In this analysis, ARR and relapse EDSS did not suggest a clinically meaningful reactivation or rebound after ponesimod discontinuation within the available follow-up. Real-world data with longer follow-up are needed to confirm these findings."

CNS Disorders • Multiple Sclerosis

Effectiveness and safety of Ponesimod in Relapsing Multiple Sclerosis: results from an Italian multicenter real-world observational study (EAN 2026) - "Background and aims: In 2021, the phase III OPTIMUM trial demonstrated the efficacy of Ponesimod (PON) - a sphingosine-1-phosphate receptor modulator - over teriflunomide in treating Relapsing Multiple Sclerosis (RMS). In this Italian real-world study, PON showed high effectiveness in controlling clinical and radiological disease activity, with a favourable safety and tolerability profile."

Clinical • Observational data • Real-world • Real-world evidence • CNS Disorders • Infectious Disease • Multiple Sclerosis

Long-term efficacy and safety of ponesimod in females and males: post-hoc analysis of the ponesimod long-term extension trial (EAN 2026) - " After 108 weeks of double-blind treatment with ponesimod 20 mg (P) or teriflunomide 14 mg (T) in the core OPTIMUM study, participants were offered ponesimod 20 mg in the OLE for up to 5 years. Ponesimod demonstrated sustained long-term efficacy and safety with comparable outcomes in both sexes. These results support consistent use of ponesimod across both sub-populations."

Clinical • Retrospective data • CNS Disorders • Infectious Disease • Multiple Sclerosis • Nephrology

Ponesimod efficacy and safety in relapsing multiple sclerosis patients with mild to moderate disability: results from OPTIMUM and long-term extension (EAN 2026) - "Background and aims: OPTIMUM was a phase 3 trial comparing ponesimod with teriflunomide in relapsing multiple sclerosis (RMS). In patients with baseline EDSS ≤3.5, ponesimod showed sustained clinical and magnetic resonance imaging efficacy across OPTIMUM and the LTE with a favorable safety profile."

Clinical • CNS Disorders • Multiple Sclerosis

Efficacy and safety of ponesimod in patients aged 50 years or older in OPTIMUM and its long-term extension (EAN 2026) - "Background and aims: OPTIMUM was a 2-year phase 3 trial comparing ponesimod with teriflunomide in relapsing multiple sclerosis. In this post-hoc analysis of patients aged 50 years or older, ponesimod demonstrated sustained clinical and imaging efficacy with a favorable safety profile. These findings require confirmation in larger real-world cohorts."

Clinical • CNS Disorders • Multiple Sclerosis

Post-hoc analysis ofthe OPTIMUM long-term extension study: Preservation of independent ambulation in patients treated with Ponesimod (EAN 2026) - " Following 108 weeks of double-blind treatment with ponesimod 20 mg or teriflunomide 14 mg in the core OPTIMUM study, participants could enter the long-term extension (LTE) and receive open-label ponesimod 20 mg. This post-hoc analysis of OPTIMUM-LTE shows a sustained preservation of mobility and functional independence with ponesimod over up to 7 years of follow-up, supporting its durable efficacy in patients with RMS."

Clinical • Retrospective data • CNS Disorders • Multiple Sclerosis