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Teriflunomide is a small molecule immunomodulatory agent used to treat relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease. It is the active metabolite of leflunomide and acts primarily by selectively, reversibly, and non-competitively inhibiting the mitochondrial enzyme dihydroorotate dehydrogenase. This inhibition blocks de novo pyrimidine synthesis, leading to reduced proliferation of activated T and B lymphocytes involved in MS pathogenesis while sparing resting cells. Teriflunomide has anti-inflammatory properties and reduces nerve damage associated with MS[1][3][5][8]. Developers: Sanofi/Genzyme
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