Disease modifying antirheumatic drug (DMARD) with immunosuppressant activity. Converted in vivo to its active open ring metabolite, teriflunomide, q.v. Inhibits de novo pyrimidine biosynthesis in immune cells. Prepn: F. J. Kaemmerer, R. Schleyerbach, DE 2854439; eidem, US 4284786 (1980, 1981 both to Hoechst); and pharmacology: P. Fossa et al., Farmaco 46, 789 (1991). HPLC determn of active metabolite in plasma: V. C. Dias et al., Ther. Drug Monit. 17, 84 (1995). Review of mechanisms of action: R. I. Fox, J. Rheumatol. 25, Suppl. 53, 20-26 (1998); of clinical pharmacology: B. Rozman, ibid. 27-32. Clinical trial in rheumatoid arthritis: V. Strand et al., Arch. Intern. Med. 159, 2542 (1999). Reviews: C. Miceli-Richard, M. Dougados, Expert Opin. Pharmacother. 4, 987-997 (2003); J. P. Kaltwasser, F. Behrens, ibid. 6, 787-801 (2005).
Antirheumatic.
Antiarthritic/Antirheumatic; Immunomodulator