Talk:Teriflunomide

Structure
Is the double bond really Z? I only found this structure on the web (Prous, ÖAZ, FreePatentsOnline (image), FreePatentsOnline (text)), but the formula on A77 1726 (seems to be deleted now) showed E. E also seems to be the natural outcome of the activation reaction. --ἀνυπόδητος (talk) 20:14, 10 September 2008 (UTC)


 * Teriflunomide might not be the same as A77 1726, contrary to Drugs of the Future. PubChem has
 * an id 5479847 for teriflunomide (calling it the active metabolite of leflunomide) with a link to the MeSH entry on A77 1726
 * and an id 16760239 for A77 1726 (which ís the active metabolite of leflunomide according to the Wikipedia article A77 1726).
 * I removed the references to the identity of teriflunomide and A77 1726 (on Leflunomide and Therapies under investigation for multiple sclerosis as well) --ἀνυπόδητος (talk) 17:16, 11 September 2008 (UTC)
 * According to rINN list 42, the double bond is Z, and the structure of teriflunomide corresponds to (nitrile, not isocyanide). Martindale also states: "After oral doses leflunomide undergoes first-pass metabolism to A771726 (teriflunomide)". See also, , and . Image:A77 1726.png was deleted from Commons by the uploader himself, Edgar181, as "incorrect chemical structure".
 * I think it's safe to say teriflunomide and A77 1726 are one and the same, and is incorrect. Fvasconcellos (t·c) 17:46, 11 September 2008 (UTC)
 * Chemical Abstracts lists teriflunomide and A 77-1726 as synonyms under CAS#163451-81-8 with structure and Z-geometry matching what's in the drugbox now. PubChem is error prone, so I wouldn't worry that one structure there doesn't match.  This is why I changed the PubChem link in this article and deleted the original image I created Image:A77 1726.png which was based on that wrong PubChem listing.  The issue of the double bond geometry is a minor point, in my mind.  The E form will be the one produced by metabolism, but the structure will actually interconvert between the E/Z enolic forms and the corresponding keto-amide, with the Z enol being the most stable and therefore most predominant form.  -- Ed (Edgar181) 20:14, 11 September 2008 (UTC)

I have taken a look at quite a few journal articles published on teriflunomide, including the Drugs of the Future review cited in the article. It is clear that the literature consistently treats teriflunomide and A 77-1726 as synonyms. I have therefore reverted the article back to one of Anypodetos' earlier versions. If anyone objects, please let me know. -- Ed (Edgar181) 20:35, 11 September 2008 (UTC)
 * Thanks for taking the trouble! I will revert Leflunomide and Therapies under investigation for multiple sclerosis as well. And thanks for reminding me of the enolic E/Z conversion thing - seems I'm forgetting chemistry... --ἀνυπόδητος (talk) 20:46, 11 September 2008 (UTC)

Tenere trial
According to the FDA's clinicaltrials.gov website The Tenere Trial WAS NEVER POWERED to be a "Superiority" trial just a COMPARISON TRIAL. Here is the Official Verbage on TENERE from www.clinicaltrials.gov (FDA) -

Purpose Primary objective was to assess the effectiveness evaluated by the time to failure of two doses of teriflunomide in comparison to (NOT SUPERIOR TO) interferon beta-1a in patients with relapsing Multiple Sclerosis [MS]. Secondary objectives were: •To assess the effect of the two doses in comparison to interferon beta-1a on: ◦Frequency of relapses, ◦Fatigue, ◦Patient's satisfaction with treatment. •To evaluate the safety and tolerability of the two doses in comparison to interferon beta-1a. The study consisted of a core treatment period with a common end date defined as 48 weeks after randomization of the last participant, followed by an optional long-term extension treatment period until teriflunomide is commercially available in accordance with local regulations.

In contrast, The Gilenya TRANSFORMS study was a superiority study. The Primary Outcome of the Transforms Study was - "This study assessed the safety, tolerability, and efficacy of 2 doses of oral fingolimod versus interferon β-1a to reduce the frequency of relapses in patients with relapsing-remitting multiple sclerosis." Versus means to compete

Please make the correction. — Preceding unsigned comment added by 199.245.32.209 (talk) 17:19, 6 December 2013 (UTC)


 * Changed wording. Thanks for catching that. By the way, you can fix errors on Wikipedia yourself. Just be bold! Cheers --ἀνυπόδητος (talk) 07:50, 7 December 2013 (UTC)