Assessment of Total Side Effects of Oral Agents for the Treatment of Relapsing–Remitting Multiple Sclerosis Patients in Imam Khomeini Clinic in Hamadan

Three oral drugs, including fingolimod, dimethyl fumarate, and teriflunomide, which are clinically approved for the therapy of relapsing–remitting multiple sclerosis (RRMS) were reviewed in this work. The present study aimed to recognize the side effects of the oral drugs in RRMS patients who were consulted in neurology clinic in west of Iran.

The study population of the present prospective observational study conducted in 2016-2017 were patients with relapsing-remitting MS referred to Imam Khomeini Hospital (RA). Three hundred patients with RRMS were randomly assigned to three treatment groups. The first group received fingolimod, the second group received dimethyl fumarate, and the third group received teriflunomide. The response to treatment assessed at 1, 3, 6, 12, and 24 months after the start of treatment. Eventually, the frequency of adverse effects characterized for each group and the collected data compared in each treatment group. The collected data were analyzed using ANOVA statistical tests.

The findings of the present study revealed that the most common clinical complications were neurological (21.8%) and gastrointestinal complications (15.6%). The most common laboratory complications were liver (12.9%) and cardiovascular complications (10.3%). Moreover, the lowest clinical complications were musculoskeletal (4.6%) and endocrine complications (3%) and lowest laboratory complications were macular edema (0.6%).

In the present study, fingolimod had the most side effects and triflunomide had the least side effects. Dimethyl fumarate was stopped due to the severity of side effects and triflunomide was continued.