Abstract Details

Title Safety and Efficacy of Teriflunomide on Clinical Course, and Laboratory Findings in Patients With HTLV-1-associated Myelopathy/Tropical Spastic Paraparesis

Topic Infectious Disease

Presentation(s) S9 - Neuroinfectious Disease: Associations and Outcomes (5:06 PM-5:18 PM)

Poster/Presentation
Number 009

Objective HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic inflammatory disease of the central nervous system (CNS).

Background Teriflunomide is an oral agent developed for the treatment of multiple sclerosis (MS) by suppressing the proliferation of autoreactive lymphocytes. This study was conducted to evaluate the efficacy of teriflunomide in HAM/TSP patients in Northeast Iran.

Design/Methods This study was a triple-blind, randomized, placebo-controlled trial involving 22 patients with HAM/TSP. The intervention group (n = 11) received one tablet of teriflunomide (14 mg daily), while the control group (n = 11) received one placebo tablet for 12 months. Muscle strength, spasticity, motor disability, urinary disorders, walking speed, laboratory factors, and drug complications were examined during the study.

Results In the intervention group, consumption of teriflunomide decreased the duration of walking according to the T25FW test (p = 0.01). The severity of OMDS disability also significantly decreased (P < 0.001). Additionally, the total score of UDS in the intervention group decreased. The levels of HTLV-1 proviral load significantly decreased (p = 0.003). No adverse effects were observed, and the increase in liver enzyme levels was tolerable and controllable.

Conclusions Teriflunomide effectively reduced the proviral load, improved the severity of disability and walking speed, and better controlled urinary and constipation symptoms without any adverse effects. Therefore, teriflunomide can be considered a disease-modifying therapy for patients with HAM/TSP. However, further studies with a large number of patients and longer duration, along with the determination of specific HAM/TSP-associated biomarkers, are needed to validate the results of
the present study.

Authors/Disclosures
Mohammadali Nahayati, MD PRESENTER	Dr. Nahayati has received personal compensation for serving as an employee of abidi. Dr. Nahayati has received personal compensation for serving as an employee of Orrchid pharmed. Dr. Nahayati has received personal compensation for serving as an employee of zistdaru danesh. Dr. Nahayati has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for abidi. Dr. Nahayati has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for zistdaru danesh. Dr. Nahayati has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Orchispharmed. Dr. Nahayati has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for abidi. Dr. Nahayati has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Orchidpharmed.
Neda Ghadiri, MD	Miss Ghadiri has nothing to disclose.
Reza Boostani, MD	No disclosure on file

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