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Aubagio (teriflunomide)

Other names: teriflunomide

Aubagio is a disease modifying drug for relapsing remitting MS.

You take Aubagio as a pill once a day to reduce the number and severity of relapses. It reduces the number of relapses by about one third (30%), compared to taking placebo.

Common side effects include feeling sick, diarrhoea and hair thinning.

What is Aubagio used for in MS?

Aubagio is a disease modifying drug (DMD) for relapsing remitting MS. You have fewer relapses than you might have had with no treatment and any relapses you do have should be less severe.

Aubagio is moderately effective (category 1.1) DMD; in clinical trials people taking Aubagio had about 30% fewer relapses than people taking placebo. In clinical trials, MRI scans showed people taking Aubagio had fewer, smaller or no new areas of active MS (lesions). Aubagio may also slow down the build-up of disability associated with MS.

Who can take Aubagio?

Aubagio can be prescribed for adults with active relapsing remitting MS. NHS approval excludes people who have very active MS (this covers highly active despite treatment with another DMD or rapidly evolving severe relapsing remitting MS).

Aubagio has been approved for use on the NHS since 2014. It can only be prescribed by a neurologist.

Contraindications

It's important that you tell your MS team if you have any health problems or are taking other medicines. Aubagio may not be appropriate if you have existing medical conditions including: severe liver problems, serious problems affecting the immune system (eg AIDS) and significant problems affecting bone marrow or reduced blood cell counts (eg anaemia, leucopenia, neutropenia or thrombocytopenia).

How do I take Aubagio?

You take Aubagio as a pill, once daily.

What side effects could I get with Aubagio?

Common side effects of treatment include feeling sick, diarrhoea and hair thinning which can occur during the first few months of treatment but generally improve in following months. Increased blood levels of liver enzymes can also occur.

Common side effects (affecting more than 1 person in 100)

  • increased levels of liver enzymes
  • nausea and diarrhoea
  • hair thinning and loss
  • urinary tract infection
  • inflammation of the nose and throat
  • influenza
  • pins and needles
  • infections
  • decrease in white blood cells (neutropenia)
  • mild allergic reactions
  • anxiety
  • nerve pain
  • decrease in red blood cells (anaemia)
  • increase in blood pressure
  • rash
  • musculoskeletal pain

Less common side effects (affecting less than 1 person in 100)

  • decrease in blood platelets (thrombocytopenia)
  • peripheral neuropathy

A full list of side effects is included in the manufacturer's Patient Information Leaflet.

Assessment before treatment

Before starting Aubagio, you should have blood tests to measure blood cell counts and check liver function. Blood pressure will also be checked.

As Aubagio must not be taken during pregnancy, women of child-bearing age may be offered a pregnancy test.

Assessment during treatment

Once you've started treatment you'll have blood tests to monitor liver function, generally every 2 weeks for the first 6 months and every 8 weeks thereafter. Depending on local practise, the tests may be carried out at a local GP surgery or it may be necessary to attend a hospital clinic.

Blood pressure and blood cell counts will also be monitored periodically during treatment.

How does Aubagio work?

The mechanism of action of Aubagio is not completely understood, but it is thought that the main effect is to stop certain immune cells from multiplying. This results in lower numbers of both B-cells and T-cells, two types of white blood cell involved in the damage associated with MS.

Aubagio research

What are the results so far?

Three main studies have provided the evidence to support approval of Aubagio for multiple sclerosis:

  • TEMSO - Aubagio compared to placebo

TEMSO was a two year, double-blind study of 1088 people with relapsing remitting MS, comparing two doses of Aubagio with placebo. Compared to placebo, the drug reduced the number of relapses in one year by 31%. The higher dose also reduced disability progression by 29.8% compared to placebo.

  • TOWER - Aubagio compared to placebo

TOWER tested two different doses of Aubagio or placebo for at least 48 weeks in 1169 people with relapsing remitting MS. Compared to placebo, the higher dose reduced the number of relapses in one year by 36%. The higher dose of Aubagio reduced the risk of disability progression by 31.5%.

  • TENERE - Aubagio compared to Rebif

This study compared two doses of Aubagio with Rebif (interferon beta 1a) in 324 people over two years. The main measure of the study was the time to first relapse or stopping treatment for any reason. There was no difference in this measure between either dose of Aubagio or Rebif. The number of relapses in one year was approximately the same for Rebif and the higher dose of Aubagio.

Last updated: November 2017
Last reviewed: September 2015
This page will be reviewed within three years