Multiple sclerosis (MS) is the autoimmune, demyelinating, neurodegenerative 
disorder of the central nervous system (CNS). There are nine drugs available in 
Hungary reimbursed by the National Health Insurance Fund of Hungary (OEP) to 
reduce the activity of the disease, from which seven can be used as first line 
therapies. We have approximately 20 years of experience with the interferon 
beta-1a/1b and glatiramer-acetate products. Though in case of approximately 30% 
of the patients using one of the first line drugs, the disease remains active, 
that we call break-through disease. The reasons for breakthrough disease could 
be the insufficient adherence and compliance, the appearance of neutralizing 
antibodies or the high activity of the disease. One of the oral immunomodulating 
drugs for MS, teriflunomide, was registered in Europe in 2013. Because of the 
anti-proliferative and anti-inflammatory effect of teriflunomide, it can be used 
for the reduction of the disease activity in the relapsing-remitting course of 
MS. The effect of teriflunomide was proved in one Phase II. and four Phase III. 
(TEMSO, TOWER, TENERE, TOPIC) studies. Teriflunomide 14 mg once daily was able 
to demonstrate in two consecutive placebo-controlled phase 3 clinical trials 
that significantly reduces the relapse rate (31.5% and 36.3%) and in both 
studies significantly reduces the sustained disability progression (29.8% and 
31.5%) moreover delays the appearance of the clinically definitive MS in 
patients with clinically isolated syndrome (CIS). According to the TENERE study 
there were no significant differences observed between teriflunomide 14 mg and 
IFNβ-α a s.c. in time to failure and annualized relapse rate but the treatment 
satisfaction domains of global satisfaction, side-effects and convenience were 
significantly improved with teriflunomide compared with s.c. IFNβ-α.