Table 3.

Emerging MS DMTs.

EMERGING MULTIPLE SCLEROSIS DISEASE-MODIFYING THERAPIES
	TERIFLUNOMIDE	DIMETHYL FUMARATE	ALEMTUZUMAB	LAQUINIMOD
Brand name	Aubagio	Tecfidera	Lemtrada	–
Mechanism of action	Selectively and reversibly inhibits a mitochondrial enzyme necessary for de novo pyrimidine synthesis: dihydroorotate dehydrogenase (DHODH)	Activation of the nuclear factor (erythroid-derived 2)-like 2 (Nrf2) antioxidant response pathway	Anti-CD52 monoclonal antibody	Reduces leukocyte migration into the CNS through downregulation of VLA-4-mediated adhesiveness
Year approved	2012	2013	2013*	–
Dose	7 or 14 mg	240 mg	12 mg	–
Route	Oral	Oral	Intravenous	Oral
Frequency	Daily	Twice daily	Annual course	Daily
Most relevant side effects	Lymphopenia, elevated liver enzymes, hypertension, nausea, diarrhea, peripheral neuropathy, acute renal failure, hair thinning and teratogenicity	Flushing, gastrointestinal events (diarrhea, nausea and upper abdominal pain: higher in the first month of treatment, decreasing thereafter), reduction in lymphocyte counts and elevated liver enzymes	Infusion reactions, thyroid disease and thrombocytopenia	Elevated liver enzymes

Note:

^*Approved only by EMA; pending approval by FDA.