Profile of oral laquinimod and its potential in the treatment of multiple sclerosis

Matthew S West, Augusto MiravalleDepartment of Neurology, University of Colorado, Denver, CO, USAAbstract: The medications available to treat relapsing-remitting multiple sclerosis (RRMS) are expanding as newer, and more potent, disease-modifying treatments become available. In particular, there is an impetus for safe and effective oral options. Laquinimod is a novel oral immunomodulator currently under investigation for the treatment of RRMS. Although the exact mechanism of action is not known, laquinimod is not an immunosuppressant. Rather, it appears to have multiple effects on the immune system, including a shift to an anti-inflammatory cytokine state, reduction in antigen presentation, and effect on migration of T cells. In addition, laquinimod may have a neuroprotective effect. Phase II trials of RRMS patients showed a statistically significant reduction in magnetic resonance imaging (MRI) outcomes, such as decrease in gadolinium-enhancing lesions, and initial Phase III data have now shown a reduction in relapse rate, reduction in sustained disability, and a decrease in atrophy on brain MRI. In all trials, laquinimod has shown a favorable tolerability and safety profile. Laquinimod has been granted fast-track status by the US Food and Drug Administration, and may become an approved treatment for RRMS.Keywords: laquinimod, multiple sclerosis, mechanism of action, efficacy