- The recent approvals of both teriflunomide (Aubagio®) and alemtuzumab (Lemtrada®) have meant that substantially more can now be offered to patients with multiple sclerosis (MS). In clinical trials, teriflunomide has shown consistent efficacy across patients with early disease (TOPIC study, n=618) and in patients with relapsing forms of MS (TEMSO, n=1,088 and TOWER studies n=1,169). Teriflunomide 14 mg/day showed consistent efficacy in patients with varying levels of disease activity and is the only approved oral MS therapy that significantly delayed disability progression in two phase III clinical trials. The safety profile of teriflunomide now extends to 12 years and the data support its use as a platform agent in patients with relapsing MS (RMS). In other phase II and III clinical trials (CAMMS223, n=334, CARE-MS 1, n=581 and CARE-MS 2, n=840), alemtuzumab has demonstrated superior efficacy (clinical and magnetic resonance imaging [MRI]) than high-dose subcutaneous (s.c.) interferon beta (IFNβ-1a). It has also shown improvement in pre-existing disability compared with IFNβ-1a s.c. and sustained efficacy over 3–4 years despite no further therapy after the second administration in the majority of the patients. Alemtuzumab has a consistent, well-characterised safety profile, so adverse events can be identified and managed using a comprehensive safety monitoring and education programme. Both teriflunomide and alemtuzumab therefore have favourable benefit– risk profiles in patients with early and/or active RMS. Their efficacies constitute real advances in MS treatment and in regular clinical use are likely to effectively control disease and improve outcomes for many MS patients.