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Kallmann BA, Ries S, Kullmann JS, Quint LM, Engelmann U, Chan A. Teriflunomide in relapsing-remitting multiple sclerosis: outcomes by age and pre-treatment status. Ther Adv Neurol Disord 2021; 14:17562864211005588. [PMID: 34046085 PMCID: PMC8135216 DOI: 10.1177/17562864211005588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background and aims: To investigate effectiveness and safety of teriflunomide (14 mg once daily) in association with age and pre-treatment in unselected MS patients. Methods: Prespecified analysis of a non-interventional, prospective, real-world study in Germany. Results: A total of 558 (49.5%) patients were above 45 years old, and 593 patients (52.6%) had been pre-treated within 6 months prior to teriflunomide. Baseline Expanded Disability Status Scale (EDSS) was higher with older age, with lower number of relapses. Relapse rate decreased in all age groups, and in both treatment-naïve (0.82 ± 0.73 at baseline; 0.25 ± 0.55 under teriflunomide) and pre-treated (from 0.48 ± 0.76; 0.22 ± 0.50) patients after 12 months compared with the year before teriflunomide initiation. EDSS remained stable in patients of all age groups as well as in therapy-naïve and pre-treated patients over 24 months. The percentage of patients with adverse events (AEs) ranged between 29.2% (age group >25–35) and 38.9% (age group >55–65), with an increased discontinuation rate (most commonly due to diarrhoea, alopecia and nausea) in the higher age groups. AE rates were lower in pre-treated compared with treatment-naïve patients. Conclusion: Overall, patients of all age groups including older patients, and irrespective of pre-treatment, benefit from teriflunomide treatment in routine clinical practice. Registration: BfArM public study database number 2075.
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Affiliation(s)
| | | | | | - Laura M Quint
- Medical Affairs, Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany
| | - Ulrich Engelmann
- Country MS Medical Head SGZ, Medical Affairs, Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, K703, 65926 Frankfurt, Germany
| | - Andrew Chan
- Department of Neurology, Bern University Hospital, University of Bern, Switzerland
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Li J, Wu DM, Yu Y, Deng SH, Liu T, Zhang T, He M, Zhao YY, Xu Y. Amifostine ameliorates induction of experimental autoimmune encephalomyelitis: Effect on reactive oxygen species/NLRP3 pathway. Int Immunopharmacol 2020; 88:106998. [PMID: 33182064 DOI: 10.1016/j.intimp.2020.106998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Abstract
Multiple sclerosis (MS) is an autoimmune disease for which conventional treatments have limited efficacy or side effects. Free radicals are primarily involved in blood-brain barrier disruption and induce neuronal and axonal damage, thus promoting the development of MS. Amifostine, a radioprotective drug used as a cytoprotective agent, attenuates oxidative stress and improves radiation damage by acting as a direct scavenger of reactive oxygen and nitrogen species. The aim of this study was to evaluate the effects of amifostine on MS in a mouse model of experimental autoimmune encephalomyelitis (EAE), which was developed by immunizing C57BL/6 mice with myelin oligodendrocyte glycoprotein and pertussis toxin. EAE mice received intraperitoneal injections of amifostine prior to onset of clinical symptoms and were monitored up to day 15 post induction. We observed abnormal clinical behavioral scores and a decrease in body weight. Histological analysis showed severe inflammatory infiltration and demyelination in the brain and spinal cord lumbar enlargements where significant upregulation of the mRNA expression of the pro-inflammatory cytokines interleukin-6 and interleukin-8, downregulation of the anti-inflammatory cytokine interleukin-10, and obvious microgliosis were also observed. Amifostine treatment potently reversed these abnormal changes. The anti-inflammatory effect of amifostine was associated with the inhibition of reactive oxygen species generation. Furthermore, the expression of proteins involved in the NLRP3 signaling pathway and pyroptosis was decreased. In conclusion, our study showed that amifostine ameliorates induction of experimental autoimmune encephalomyelitis via anti-inflammatory and anti-pyroptosis effects, providing further insights into the use of amifostine for the treatment of MS.
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Affiliation(s)
- Jing Li
- Clinical Laboratory, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, 278 Baoguang Road, Chengdu, Sichuan 610500, PR China; Collaborative Innovation Center of Sichuan for Elderly Care and Health of Chengdu Medical College, Baoguang Road, Chengdu, Sichuan 610041, PR China
| | - Dong-Ming Wu
- Clinical Laboratory, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, 278 Baoguang Road, Chengdu, Sichuan 610500, PR China; Collaborative Innovation Center of Sichuan for Elderly Care and Health of Chengdu Medical College, Baoguang Road, Chengdu, Sichuan 610041, PR China
| | - Ye Yu
- Clinical Laboratory, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, 278 Baoguang Road, Chengdu, Sichuan 610500, PR China; Collaborative Innovation Center of Sichuan for Elderly Care and Health of Chengdu Medical College, Baoguang Road, Chengdu, Sichuan 610041, PR China
| | - Shi-Hua Deng
- Clinical Laboratory, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, 278 Baoguang Road, Chengdu, Sichuan 610500, PR China; Collaborative Innovation Center of Sichuan for Elderly Care and Health of Chengdu Medical College, Baoguang Road, Chengdu, Sichuan 610041, PR China
| | - Teng Liu
- Clinical Laboratory, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, 278 Baoguang Road, Chengdu, Sichuan 610500, PR China; Collaborative Innovation Center of Sichuan for Elderly Care and Health of Chengdu Medical College, Baoguang Road, Chengdu, Sichuan 610041, PR China
| | - Ting Zhang
- Clinical Laboratory, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, 278 Baoguang Road, Chengdu, Sichuan 610500, PR China; Collaborative Innovation Center of Sichuan for Elderly Care and Health of Chengdu Medical College, Baoguang Road, Chengdu, Sichuan 610041, PR China
| | - Miao He
- Clinical Laboratory, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, 278 Baoguang Road, Chengdu, Sichuan 610500, PR China; Collaborative Innovation Center of Sichuan for Elderly Care and Health of Chengdu Medical College, Baoguang Road, Chengdu, Sichuan 610041, PR China
| | - Yang-Yang Zhao
- Clinical Laboratory, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, 278 Baoguang Road, Chengdu, Sichuan 610500, PR China; Collaborative Innovation Center of Sichuan for Elderly Care and Health of Chengdu Medical College, Baoguang Road, Chengdu, Sichuan 610041, PR China
| | - Ying Xu
- Clinical Laboratory, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, 278 Baoguang Road, Chengdu, Sichuan 610500, PR China; Collaborative Innovation Center of Sichuan for Elderly Care and Health of Chengdu Medical College, Baoguang Road, Chengdu, Sichuan 610041, PR China.
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