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Systematic review of 6 phase II and III trials of teriflunomide in relapsing multiple sclerosis reports ALT elevations above 3 times ULN in 12-14% of teriflunomide vs 7% of control subjects; no mention of clinically apparent liver injury).

improvements seen with methotrexate were significantly greater than those with leflunomide

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We do not evaluate the conventional DMARDs or other rheumatoid arthritis treatments, or compare them with biologics.

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Encourage patients 50 years and older to get the Shingrix vaccine.

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