Studied for the first time, Aubagio (teriflunomide) slowed the loss of cortical grey matter and whole-brain volume in people with clinically isolated syndrome (CIS) during two years of therapy, a study found. The treatment was especially effective in those without brain lesions before treatment.
Further, the study showed that early cortical and whole-brain atrophy is associated with CIS becoming definite multiple sclerosis (MS) in the following years.
While these measures alone were unable to predict CIS converting to MS, the findings support the relevance of cortical and whole-brain atrophy as well as early Aubagio treatment in CIS patients.
The study, “Slowing of brain atrophy with teriflunomide and delayed conversion to clinically definite MS,” was published in the journal Therapeutic Advances in Neurological Disorders.
The likelihood of a person with CIS developing clinically definite MS depends on the presence or absence of brain lesions in the white matter of the brain, as detected by MRI scans. But studies of CIS and early MS have detected lesions in the gray matter of the cerebral cortex — the brain’s outer layer — that develop before white matter lesions.
In addition, evidence suggests shrinkage (atrophy) of the whole brain (WB) and cortical gray matter (CGM) can predict CIS conversion to MS, with gray matter atrophy associated with increasing disability and cognitive impairment.
In the Phase 3 TOPIC study (NCT00622700), 14 mg of Aubagio, given once-daily over two years, significantly reduced the risk of CIS patients developing definite MS, compared with a placebo. Moreover, recent evidence suggests that Aubagio may slow cortical grey matter and whole-brain atrophy.
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