Teriflunomide did not differ from placebo for time to first confirmed clinical relapse, but it may have some benefit for children with relapsing MS, according to a study published in The Lancet Neurology. Tanuja Chitnis, MD, and colleagues conducted a phase III trial of children aged 10-17 with relapsing MS. Patients were randomly assigned to oral teriflunomide or matching placebo for up to 96 weeks; those with confirmed clinical relapse or high MRI activity were able to enter a subsequent 96- week open-label extension phase before the end of the double-blind period. Switches to the extension phase due to high MRI activity occurred more frequently than anticipated in the placebo group (26% vs 13% for the teriflunomide group), reducing the study’s power. After 96 weeks, no difference was seen in time to first confirmed clinical relapse with teriflunomide versus placebo (HR, 0.66; 95% CI, 0.39-1.11). There was a decrease in the number of new or enlarged T2 lesions with teriflunomide compared with placebo (relative risk [RR], 0.45; 95% CI, 0.29-0.71) and in the number of gadolinium-enhancing lesions (RR, 0.25; 95% CI, 0.13-0.51).
Patient Sex, Mental Health Impact COVID-19 Recovery in Those With MS
Patients with MS experience post-acute sequelae after COVID-19 infection, and severe neurologic impairment or mental health problems may increase incidence of this sequelae, according to results published in Neurology. Investigators performed a prospective, longitudinal cohort study of patients with MS who reported COVID-19 between March 17, 2020 and March 19, 2021 in order to understand recovery from COVID-19 in this patient population, as well as predictors of recovery. They obtained information on COVID-19 symptom duration from those who had not recovered at the last follow-up visit in addition to demographic and clinical data from all participants. Among 7,977 patients with MS, 599 reported COVID-19 and prospectively updated recovery status; the study team excluded 28 hospitalized participants. At least 165 participants (29.7%) had long-standing COVID-19 symptoms for 4 or more weeks and 69 (12.4%) for 12 or more weeks. Those with pre-COVID-19 Expanded Disability Status Scale scores greater than or equal to 7, participants with probable anxiety and/or depression before COVID-19, and women were less likely to report recovery from COVID-19.