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Digestive side-effects with teriflunomide: Thoughts on lactose.

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Area of Science:

  • Neurology
  • Gastroenterology
  • Pharmacology

Background:

  • Teriflunomide is an oral medication for relapsing-remitting multiple sclerosis (RRMS).
  • Digestive disorders are common adverse reactions, and the drug contains lactose.
  • Patients with lactose intolerance are advised against its use.

Purpose of the Study:

  • To investigate the incidence of undiagnosed lactose intolerance in RRMS patients experiencing digestive side effects from teriflunomide.
  • To assess the utility of lactose breath testing in managing these adverse events.

Main Methods:

  • A prospective study of 100 RRMS patients initiating teriflunomide.
  • Systematic collection of adverse events and inquiry about known lactose intolerance.
  • Lactose breath tests (LBT) performed for persistent diarrhea.

Main Results:

  • No patients initially reported known lactose intolerance.
  • 14% experienced mild-to-moderate diarrhea; four had persistent symptoms.
  • Lactose breath tests confirmed lactose intolerance in these four patients, with symptom resolution upon management.

Conclusions:

  • Prolonged digestive side effects with teriflunomide warrant investigation for lactose malabsorption.
  • Lactose breath testing is a valuable tool to identify lactose intolerance as a cause of adverse events.
  • This can aid in continued teriflunomide treatment and symptom management.