Dimethyl fumarate: a novel drug for multiple sclerosis.
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Date
2014-11
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Abstract
Dimethyl fumarate (DMF) is a novel oral immunomodulatory and neuroprotective
drug that was approved by FDA for relapsing forms of multiple sclerosis (MS). The
initial use of DMF was for the treatment of psoriasis where its long-term use was
safe and efficacious, and it also got German approval for the same. It was found that
the anti-inflammatory actions of DMF contributed to its efficacy in psoriasis. This
anti-inflammatory action of DMF created interest using DMF in other auto-immune
or inflammatory diseases, including MS. DMF acts by decreasing production and
release of inflammatory molecules. DMF also activates the nuclear factor-erythroid
2 related factor pathway which induces the transcription of various genes, including
anti-oxidative ones, reduces oxidative neuronal death and helps maintain myelin
integrity. Thus, DMF acts via two pathways: by down-regulating oxidative stress and
corresponding cellular injury, as well as by inhibiting pro-inflammatory cytokines.
DMF is an orally administered, enteric-coated microtablet preparation. There was
a 44-53% reduction in annualized relapse rate with the use of DMF in patients with
relapsing form of MS. The most common adverse reactions reported are flushing,
abdominal pain, diarrhea, and nausea, which are more prominent during initial
treatment and usually decrease over time. No serious adverse events were seen during
the phase II and III trials, including no increased risk of opportunistic infections or
cancer. DMF seems to approach the ideal combination of safety, efficacy and welltolerability
to other approved oral therapies for MS.
Description
Keywords
Dimethyl fumarate, Fumaric acids, Multiple sclerosis, Nuclear factorerythroid 2-related factor 2
Citation
Singh Jatinder, Mahajan Bharti, Kaushal Sandeep. Dimethyl fumarate: a novel drug for multiple sclerosis. International Journal of Basic & Clinical Pharmacology. 2014 Nov-Dec; 3(6): 1101-1105.