Dimethyl fumarate: the new tableted preparation for the treatment of multiple sclerosis

Abstract

Dimethyl fumarate (DMF) is dimethyl ester of fumaric acid, a naturally occurring molecule that plays a key role in redox processes of tissue respiration. Results of studies on animal models demonstrate that the drug has an anti-inflammatory and cytoprotective action. Anti-inflammatory effects of DMF could be mediated by several mechanisms, including inhibition of nuclear factor-kappaB-dependent transcription and suppression of cytokine production and cell adhesion molecule expression. 2 years after start of treatment DMF significantly increased the relative number of patients without active disease by clinical, radiological and general criteria in comparison with the placebo group. According to the DEFINE trial, the proportion of patients without active disease in twice daily DMF group was 28% (vs placebo, p = 0,012), and 18% (vs placebo, p < 0, 0001) according to the CONFIRM trial. DMF demonstrated similar efficacy in various subgroups of patients classified according to baseline characteristics of the disease, including frequency of relapses in the past, pre-treatment, level of disability, as well as type and extent of the lesions. In terms of safety profile, DMF was similar to GA and placebo. Adverse effects on the gastrointestinal tract against the background of DMF were mild or moderate, transient and treatable. Administration of DMF did not increase the risk of infections and malignancies.

Keywords

• рассеянный склероз
• диметилфумарат нейродегенерация
• оксидативный стресс
• цитопротективный эффект
• multiple sclerosis
• dimethyl fumarate
• neurodegeneration
• oxidative stress
• cytoprotective effect