Laquinimod therapy in multiple sclerosis: a comprehensive review

Area of Science:

• Neuroimmunology
• Neurodegenerative diseases
• Pharmacology

Background:

• Multiple sclerosis (MS) is an autoimmune CNS disease with inflammatory and neurodegenerative components.
• Current disease-modifying therapies (DMTs) offer partial benefits and often involve parenteral administration, impacting patient compliance.
• Laquinimod is an emerging oral drug with potential neuroprotective effects and a favorable safety profile.

Purpose of the Study:

• To review the clinical efficacy and safety of laquinimod.
• To explore the presumed mechanism of action of laquinimod.
• To provide an overview of oral DMTs for relapsing MS and remaining challenges.

Main Methods:

• Comprehensive review of clinical efficacy and safety data from two Phase III trials.
• Analysis of laquinimod's presumed mechanism of action based on in vitro and animal models.
• Overview of recently approved oral DMTs for relapsing MS.

Main Results:

• Laquinimod demonstrates a novel immunomodulatory and potential neuroprotective mechanism.
• Phase III trials ALLEGRO and BRAVO showed clinical efficacy and tolerability.
• A third Phase III study is evaluating laquinimod at a higher dosage.

Conclusions:

• Laquinimod exhibits a unique mechanism of action, combining immunomodulatory and neuroprotective properties.
• Oral DMTs like laquinimod are expected to enhance patient adherence and improve treatment outcomes.
• Further evaluation in ongoing trials will solidify laquinimod's role in managing MS.