Effect of teriflunomide on Epstein–Barr virus shedding in relapsing-remitting multiple sclerosis patients: Outcomes from a real-world pilot cohort study

•Saliva collection at home is a feasible method to detect EBV DNA and shedding.•Fewer samples from teriflunomide-treated patients with MS were positive for EBV DNA.•Fewer samples from teriflunomide-treated patients with MS were positive for EBV shedding. Given its potential antiviral activity, we investigated the effect of teriflunomide on EBV in patients with relapsing-remitting MS (RRMS). Saliva samples were collected at home and analysed for EBV DNA presence in patients with RRMS treated with teriflunomide for ≥3 months. The proportion of patients with detectable EBV in the teriflunomide cohort was lower than in the reference cohorts. The proportion of samples with EBV DNA or shedding from teriflunomide-treated patients was reduced relative to each reference cohort (P5.8 virus copies/µL cut-off). This pilot study demonstrated the feasibility of at-home saliva sample collection and revealed a possible effect of teriflunomide on EBV shedding. [Display omitted]