Dimethyl Fumarate

Dimethyl Fumarate Brand Name– Tecfidera

What is Dimethyl Fumarate

Dimethyl fumarate is indicated for the treatment of adults with relapsing forms of multiple sclerosis, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease.

Dimethyl fumarate appears to have neuroprotective and anti-inflammatory properties; these actions can help delay disability and disease progression.

In the pivotal pre-approval trial, dimethyl fumarate 240 mg twice daily led to significant reductions in the annualized relapse rate over 2 years (0.17) as compared with placebo (0.36).

The trial also showed a 38% decrease in risk of  disability progression with treatment (p=0.005) and a significant improvement in quality of life scores as early as week 24.

Similar results were found in another phase 3 trial: the annualized relapse rate over 2 years was significantly lower with dimethyl fumarate vs. placebo

Indications

  • multiple sclerosis

For the treatment of relapsing forms of multiple sclerosis, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease

Side Effects

  1. abdominal pain
  2. anaphylactoid reactions
  3. angioedema
  4. diarrhea
  5. dyspepsia
  6. elevated hepatic enzymes
  7. eosinophilia
  8. erythema
  9. flushing
  10. flushing
  11. infection
  12. leukoencephalopathy
  13. leukopenia
  14. lymphopenia
  15. lymphopenia
  16. nausea
  17. progressive multifocal leukoencephalopathy
  18. proteinuria
  19. pruritus
  20. rash
  21. vomiting

Monitoring Parameters

  • CBC with differential
  • LFTs
  • serum bilirubin

Contraindications

  • breast-feeding
  • hepatic disease
  • hepatotoxicity
  • immunosuppression
  • pregnancy
  • progressive multifocal leukoencephalopathy

Interactions

  • Diroximel Fumarate
  • Ocrelizumab
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