Teriflunomide vs injectable disease modifying therapies for relapsing forms of MS

Mult Scler Relat Disord. 2020 Aug:43:102158. doi: 10.1016/j.msard.2020.102158. Epub 2020 May 13.


Multiple sclerosis (MS) is a chronic, immune-mediated, inflammatory disease affecting the white and gray matter of the central nervous system. Several disease modifying therapies (DMTs) have been shown to significantly reduce relapse rates, slow disability worsening, and modify the overall disease course of MS. Decision-making when initiating a DMT should be shared between the patient and physician. Important factors such as prognostic indicators, safety, patient preferences, adherence, and convenience should also be considered. Treatment guidelines recommend switching a DMT when a patient experiences breakthrough disease activity, but also for patients who experience adverse events. Compared with injectable therapies, oral DMTs are often associated with increased treatment adherence and patient satisfaction, due to a less burdensome route of administration and greater tolerability. This review will summarize the available scientific evidence for injectable DMTs and the oral DMT teriflunomide, including considerations for both treatment-naïve patients initiating a DMT and patients switching from an injectable DMT.

Keywords: Disease modifying therapies; Injectable DMTs; Multiple sclerosis; Switching; Teriflunomide.

Publication types

  • Review

MeSH terms

  • Crotonates* / therapeutic use
  • Humans
  • Hydroxybutyrates
  • Immunosuppressive Agents* / therapeutic use
  • Multiple Sclerosis, Relapsing-Remitting* / drug therapy
  • Nitriles
  • Recurrence
  • Toluidines* / therapeutic use


  • Crotonates
  • Hydroxybutyrates
  • Immunosuppressive Agents
  • Nitriles
  • Toluidines
  • teriflunomide