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Serum teriflunomide concentrations in routine multiple sclerosis therapy: A cross-sectional pilot study
Zuzana Krska Kusnirikova1, Ivana Kacirova2, Veronika Pesakova2
1Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Syllabova 19, Ostrava 703 00, Czech Republic; Department of Children Neurology, Department of Neurology, University Hospital Ostrava, 17. listopadu 1790/5, Ostrava 70852, Czech Republic.
Teriflunomide serum concentrations vary greatly between multiple sclerosis patients, even at the same dose. This variability may lead to toxicity or reduced treatment effectiveness, impacting disease management.
Area of Science:
- Pharmacokinetics
- Clinical Pharmacology
- Neurology
Background:
- Teriflunomide is an oral medication used to manage relapsing-remitting multiple sclerosis.
- Understanding teriflunomide serum concentrations is crucial for optimizing treatment outcomes.
Purpose of the Study:
- To measure free and total serum teriflunomide concentrations in patients with multiple sclerosis.
- To investigate the relationship between teriflunomide levels and disease activity.
- To assess interindividual variability in teriflunomide pharmacokinetics.
Main Methods:
- A prospective pilot study involving 89 patients undergoing routine healthcare.
- Collection of blood samples for measurement of free and total teriflunomide serum concentrations.
- Monitoring of patient blood counts and adverse effects.
Main Results:
- Observed up to a 10-fold difference in total and free teriflunomide serum concentrations among patients on the same dose.
- Found a significant inverse correlation between peripheral blood lymphocyte count and teriflunomide concentrations in the steady-state group.
- Noted considerable interindividual variability in both free and total teriflunomide levels.
Conclusions:
- Significant interindividual variability in teriflunomide serum concentrations exists, even with consistent dosing.
- This variability poses risks of both toxicity and suboptimal therapeutic efficacy.
- Further research is needed to personalize teriflunomide dosing for improved multiple sclerosis management.
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