The following article is part of conference coverage from the 2018 Annual Meeting of the Consortium of Multiple Sclerosis Centers in Nashville, Tennesssee. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from CMSC 2018.

Long-term treatment of relapsing multiple sclerosis with teriflunomide is very rarely associated with grade 1 or 2 lymphopenia and not associated with grade 3 lymphopenia, according to research presented at the 32nd Annual Meeting of the Consortium of Multiple Sclerosis Centers, held May 30-June 2, 2018, in Nashville, Tennessee.

The TOPIC, TOWER, and TEMSO core and extension studies were all randomized, placebo-controlled core studies of individuals with relapsing multiple sclerosis. Analyses for the current study included all 1636 participants who were treated with teriflunomide 14 mg at any time.

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Of the 1636 patients, 92.2% (n=1508) experienced no lymphopenia, 5.4% (n=89) experienced grade 1 lymphopenia, and 2.4% (n=39) experienced grade 2. Among the 89 with grade 1 lymphopenia, 61.8% (n=55) reported infections, 3.4% (n=3) of which were serious. Among the 39 subjects with grade 2 lymphopenia, 53.8% (n=21) reported infections, 7.7% (n=3) of which were serious. These rates were similar to the reported rates of serious infections that occurred in individuals without lymphopenia (3.6%, n=55/1508). Analysis of yearly lymphocyte counts showed a declining occurrence of all grades of lymphopenia over time, and by year 9, subjects exhibited no cases of lymphopenia.

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The study investigators noted that, “Infection rates were similar in patients with or without lymphopenia, consistent with an immunomodulatory mechanism of action of teriflunomide.”

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Miller AE, Comi G, Benamor M, et al. Effect of long-term teriflunomide treatment on lymphocyte counts and infection rates in pooled data from TEMSO, TOWER, and TOPIC core and extension studies. Presented at: 2018 CMSC Annual Meeting. May 30-June 2, 2018; Nashville, Tennessee. Abstract DX47.