Pulmonary embolism in patients with multiple sclerosis treated with teriflunomide: A series of three cases

Area of Science:

• Neurology
• Pharmacology
• Pulmonology

Background:

• Teriflunomide is an oral disease-modifying therapy for relapsing-remitting multiple sclerosis (MS).
• It offers moderate efficacy with a generally favorable safety profile, though liver toxicity is a known concern.
• Pulmonary embolism (PE) is a serious condition that can affect patients with MS.

Observation:

• A series of three patients developed pulmonary embolism within two years of initiating teriflunomide.
• These patients had stable MS with low disability, and immobility was not a significant risk factor for PE.
• The observed prevalence of PE in this cohort was 2.8%.

Findings:

• Teriflunomide treatment may be associated with an increased risk of pulmonary embolism in multiple sclerosis patients.
• The risk appears present even in patients with minimal immobility.
• This suggests a potential drug-specific adverse effect beyond typical risk factors.

Implications:

• Healthcare providers should carefully assess general risk factors for pulmonary embolism before prescribing teriflunomide.
• Increased vigilance for PE symptoms is warranted in multiple sclerosis patients treated with teriflunomide.
• Further research is needed to confirm this association and elucidate the underlying mechanisms.