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Mult Scler. 2013 Sep;19(10):1310-9. doi: 10.1177/1352458513475723. Epub 2013 Feb 27.

Magnetic resonance imaging outcomes from a phase III trial of teriflunomide.

Collaborators (143)

Maida E, Auff E, Fazekas F, Berger T, Bhan V, Bouchard JP, Duquette P, Freedman M, Grand'maison F, Kremenchutzky M, Bourque C, Marrie RA, Melanson M, Patry D, O'Connor P, Oger J, Stefanelli M, Jacques F, Venegas P, Miranda M, Barrientos N, Tenhamm E, Gloger S, Rohde G, Mares J, Frederiksen J, Stenager E, Haldre S, Gross-Paju K, Elovaara I, Sumelahti ML, Erälinna JP, Erälinna JP, Färkkilä M, Harno H, Reunanen M, Jolma T, Confavreux C, Camu W, Clavelou P, Magy L, Debouverie M, Edan G, Lebrun-Frenay C, Moreau T, Pelletier J, Roullet E, Alamowitch S, Clanet M, Hautecoeur P, Damier P, Rumbach L, Chan A, Schimrigk S, Haas J, Lensch E, Diener H, Limmroth V, Anders D, Berghoff M, Oschmann P, Stangel M, Berghoff M, Frese A, Kiefer R, Marziniak M, Zettl U, Stark E, Jendroska K, Reifschneider G, Amato MP, Comi G, Cosi V, Gallo P, Gasperini C, Ghezzi A, Trojano M, Pozzilli C, Montanari E, Zwanikken CP, Jongen PJ, Centrum MS, Van Munster ET, Hupperts RM, Anten B, Sanders EA, Celius E, Hovdal H, Krogseth SB, Kozubski W, Kwiecinski H, Czlonkowska A, Stelmasiak Z, Selmaj K, Hasiec T, Fryze W, Drozdowski W, Kochanowicz J, Cunha L, De Sá J, Harrington Sena A, Odinak M, Skoromets A, Gusev E, Boiko A, Lashch N, Stolyarov I, Belova A, Malkova N, Doronin B, Yakupov E, Brundin L, Hillert J, Kappos L, Karabudak R, Irkec C, Idiman E, Turan O, Efendi H, Gedizlioglu M, Buchakchyyska N, Goloborodko A, Ipatov A, Kobets S, Lebedynets V, Moskovko S, Yushchenko OI, Sanotskyy Y, Smolanka V, Yavorskaya V, Bates D, Evangelou N, Hawkins C, McLean B, O'Riordan J, Price S, Turner B, Barnes D, Zajicek J, Honeycutt W, Khan O, Spikol L, Stevens J.

Author information

Department of Neurology, The University of Texas Health Science Center at Houston, USA.



The purpose of this study was to determine the effects of oral teriflunomide on multiple sclerosis (MS) pathology inferred by magnetic resonance imaging (MRI).


Patients (n=1088) with relapsing MS were randomized to once-daily teriflunomide 7 mg or 14 mg, or placebo, for 108 weeks. MRI was recorded at baseline, 24, 48, 72 and 108 weeks. Annualized relapse rate and confirmed progression of disability (sustained ≥12 weeks) were the primary and key secondary outcomes. The principal MRI outcome was change in total lesion volume.


After 108 weeks, increase in total lesion volume was 67.4% (p=0.0003) and 39.4% (p=0.0317) lower in the 14 and 7 mg dose groups versus placebo. Other measures favoring teriflunomide were accumulated enhanced lesions, combined unique activity, T2-hyperintense and T1-hypointense component lesion volumes, white matter volume, and a composite MRI score; all were significant for teriflunomide 14 mg and most significant for 7 mg versus placebo.


Teriflunomide provided benefits on brain MRI activity across multiple measures, with a dose effect evident on several markers. These effects were also consistent across selected subgroups of the study population. These findings complement clinical data showing significant teriflunomide-related reductions in relapse rate and disease progression, and demonstrate containment of MRI-defined disease progression.


Teriflunomide; clinical trial; disease-modifying therapy; magnetic resonance imaging; multiple sclerosis; phase III

[Indexed for MEDLINE]

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