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Dimethyl Fumarate: A Review in Relapsing-Remitting MS

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Abstract

Dimethyl fumarate (Tecfidera®) is approved for the treatment of relapsing forms of multiple sclerosis (MS). Based on evidence from the clinical trial and real-world settings, dimethyl fumarate is an effective treatment in this patient population, with benefits maintained over the longer term. In the pivotal, placebo-controlled phase III DEFINE and CONFIRM trials in adults with relapsing-remitting multiple sclerosis (RRMS), twice-daily dimethyl fumarate reduced clinical relapse and MRI measures of disease activity and improved some aspects of health-related quality of life (HR-QoL). Reduced disability progression was also observed with dimethyl fumarate in DEFINE. Results in predominantly East Asian patients (APEX trial) were reflective of those seen in DEFINE and CONFIRM. Dimethyl fumarate had an acceptable tolerability profile. The most common adverse events were flushing and gastrointestinal events, which were of mild or moderate severity and appear to be largely manageable. Thus twice-daily dimethyl fumarate remains an effective treatment option for use in patients with RRMS, with the convenience of oral administration.

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Acknowledgements

During the review process, the manufacturer of dimethyl fumarate (Biogen) was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Hannah A. Blair

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The preparation of this review was not supported by any external funding.

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Hannah Blair is a salaried employee of Adis International Ltd/Springer Nature, is responsible for the article content and declares no relevant conflicts of interest.

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Enhanced material for this Adis Drug Evaluation can be found at https://doi.org/10.6084/m9.figshare.10294838.

The manuscript was reviewed by:M.Diebold, Neurologic Clinic & Policlinic, University Hospital & University of Basel, Basel, Switzerland; M. S. Freedman, University of Ottawa & the Ottawa Hospital Research Institute, Ottawa, ON, Canada; H.–P. Hartung, Department of Neurology, Heinrich-Heine University, Dusseldorf, Germany; L.Kappos, Neurologic Clinic & Policlinic, University Hospital & University of Basel, Basel, Switzerland.

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Blair, H.A. Dimethyl Fumarate: A Review in Relapsing-Remitting MS. Drugs 79, 1965–1976 (2019). https://doi.org/10.1007/s40265-019-01229-3

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