Teriflunomide is an immunomodulatory agent primarily used for the treatment of recurrent multiple sclerosis, which can reduce recurrence rates and delay disability progression. Its therapeutic effect is significant, but stopping the medication requires following specific procedures to avoid the risk of drug residue. The following provides a detailed explanation from two aspects: treatment effectiveness and precautions for discontinuing medication.

1. Therapeutic effect

(1) Reduced recurrence rate: Clinical trials have shown that Teriflunomide 14mg/day can reduce the annual recurrence rate by about 36%, and 7mg/day can reduce it by about 22%.

(2) Delayed disability progression: The treatment group had a 30% lower risk of disability progression compared to the placebo group, and the MRI lesion activity was significantly reduced.

(3) Safety: Common adverse reactions include diarrhea, nausea, hair loss, and elevated liver enzymes, most of which are mild to moderate.

2. Precautions for discontinuation of medication

(1) Accelerated clearance program: Due to its long half-life (approximately 18 days), it is necessary to use colchicine or activated carbon adsorption to accelerate clearance, and the plasma concentration can be reduced to<0.02mg/L within 11 days.

(2) Pregnancy risk: Blood drug concentration should be continuously monitored until<0.02mg/L after discontinuation of medication. Women of childbearing age should use contraception for at least 2 years after discontinuation of medication.

(3) Liver function monitoring: Regular liver function checks are still necessary after discontinuing medication, especially for those with a history of liver disease.

(4) Infection risk: Be alert to infection, especially the risk of tuberculosis recurrence, during the recovery of immune system after drug withdrawal.