Dr. Richard Hoffmann, Ask the Pharmacist, 10/30/12

Q: I heard about a new drug for multiple sclerosis (MS) that can be taken orally. What can you tell me about it?

A: The FDA recently (2012) approved Aubagio (teriflunomide) for the treatment of patients with relapsing forms of multiple sclerosis (RMS). It is the second oral drug approved to treat MS and is taken once daily.

It is not known exactly how Aubagio works in the treatment of RMS, but it has anti-inflammatory properties and numerous effects on a patient’s immune system. During clinical studies, patients taking Aubagio experienced a 31 percent reduction in their relapse rate compared to patients taking a “dummy” pill (placebo). In addition, Aubagio treatment led to a lower number of lesions in the brain.

The most common side effects of Aubagio include liver function test abnormalities, loss of hair, diarrhea, influenza, nausea and numbness or tingling. It can also cause more serious adverse effects, including liver failure and birth defects if used during pregnancy.

MS is thought to result from a combination of inflammation and dysfunction of the immune system. It affects about 400,000 people in the United States. There are four basic presentations of MS, the most common being the relapsing form.

The exact cause of MS is unknown, but what is known is the myelin sheath, an insulating cover surrounding nerve axons, is damaged by an immune action leading to damage to the brain and spinal cord. This damage, which can be seen on MRI scans as a lesion, leads to visual disturbances, muscle weakness, coordination difficulties, and memory and cognition problems.

It most commonly occurs in people ages 20 to 40, and affects women two to three times more often than men. Common complaints include weakness, fatigue, pain, bladder and bowel problems, as well as balance, visual and other sensory disturbances. There is no cure for MS.

Strategies for treating MS include: reducing the number of attacks, reducing the number of lesions observed in MRI scans, slowing the progression of disability, and improving the speed of recovery.

Richard P. Hoffmann, Pharm.D., has been a pharmacist for more than 40 years. Send questions to him at 2960 E. Coventry Court, Hernando, FL 34442.