Fumarate treatment in progressive forms of multiple sclerosis: first results of a single-center observational study
Objectives: Therapeutic options in progressive forms of multiple sclerosis (MS) are still limited. Dimethyl fumarate (DMF) has immunomodulatory properties but may also exert antioxidative cytoprotective effects. Hence, it may be a therapeutic option for progressive MS. The aim of this observational...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2014-09-01
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| Series: | Therapeutic Advances in Neurological Disorders |
| Online Access: | https://doi.org/10.1177/1756285614544466 |
| _version_ | 1811337833492774912 |
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| author | Katrin Strassburger-Krogias Gisa Ellrichmann Christos Krogias Peter Altmeyer Andrew Chan Ralf Gold |
| author_facet | Katrin Strassburger-Krogias Gisa Ellrichmann Christos Krogias Peter Altmeyer Andrew Chan Ralf Gold |
| author_sort | Katrin Strassburger-Krogias |
| collection | DOAJ |
| description | Objectives: Therapeutic options in progressive forms of multiple sclerosis (MS) are still limited. Dimethyl fumarate (DMF) has immunomodulatory properties but may also exert antioxidative cytoprotective effects. Hence, it may be a therapeutic option for progressive MS. The aim of this observational study was to evaluate safety, adherence and efficacy of fumarates in patients with primary progressive MS (PPMS) or secondary progressive MS. Methods: Patients with progressive MS whose condition had failed to respond to standard therapies and had worsened received the fumarate mixture Fumaderm, licensed for psoriasis therapy in Germany, or DMF by pharmaceutical preparation (Bochum ethics approval no. 4797-13). At regular follow-up visits, tolerability and disease course were assessed. Results: Twenty-six patients [age 54 ± 7.8 years; female = 13 (50%); PPMS = 12 (46.2%); Expanded Disability Status Scale (EDSS) = 6.0 ± 0.4 (range 3.5–8.0); disease duration = 14.1 ± 8.7 years] were initiated on treatment with Fumaderm ( n = 18) or pharmacy-prepared DMF (n=8). During a mean follow-up period of 13.2 ± 7.5 months (range 6–30) only five patients (19.2%) reported minor complaints. In 15 patients (57.7%) EDSS remained stable. In five cases (19.2%) there was even a decrease in EDSS while in six patients (23.1%) there was an increase in EDSS of more than 0.5 points, reflecting deterioration. Laboratory values were controlled for lymphopenia, renal and hepatic values, without any safety problems. We observed no significant differences between the two pharmaceutical forms. Conclusion: Our pilot data indicate that fumarate therapy appears to be safe and well tolerated by patients with progressive MS. In more than 75% of cases no further disease progression was evident. However, controlled studies are warranted to evaluate the detailed therapeutic potential of fumarates and their long-term effects in progressive MS. |
| first_indexed | 2024-04-13T18:01:41Z |
| format | Article |
| id | doaj.art-6359f8d60b694e22b7a706a2fcb2f7a3 |
| institution | Directory Open Access Journal |
| issn | 1756-2856 1756-2864 |
| language | English |
| last_indexed | 2024-04-13T18:01:41Z |
| publishDate | 2014-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Neurological Disorders |
| spelling | doaj.art-6359f8d60b694e22b7a706a2fcb2f7a32022-12-22T02:36:14ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28561756-28642014-09-01710.1177/1756285614544466Fumarate treatment in progressive forms of multiple sclerosis: first results of a single-center observational studyKatrin Strassburger-KrogiasGisa EllrichmannChristos KrogiasPeter AltmeyerAndrew ChanRalf GoldObjectives: Therapeutic options in progressive forms of multiple sclerosis (MS) are still limited. Dimethyl fumarate (DMF) has immunomodulatory properties but may also exert antioxidative cytoprotective effects. Hence, it may be a therapeutic option for progressive MS. The aim of this observational study was to evaluate safety, adherence and efficacy of fumarates in patients with primary progressive MS (PPMS) or secondary progressive MS. Methods: Patients with progressive MS whose condition had failed to respond to standard therapies and had worsened received the fumarate mixture Fumaderm, licensed for psoriasis therapy in Germany, or DMF by pharmaceutical preparation (Bochum ethics approval no. 4797-13). At regular follow-up visits, tolerability and disease course were assessed. Results: Twenty-six patients [age 54 ± 7.8 years; female = 13 (50%); PPMS = 12 (46.2%); Expanded Disability Status Scale (EDSS) = 6.0 ± 0.4 (range 3.5–8.0); disease duration = 14.1 ± 8.7 years] were initiated on treatment with Fumaderm ( n = 18) or pharmacy-prepared DMF (n=8). During a mean follow-up period of 13.2 ± 7.5 months (range 6–30) only five patients (19.2%) reported minor complaints. In 15 patients (57.7%) EDSS remained stable. In five cases (19.2%) there was even a decrease in EDSS while in six patients (23.1%) there was an increase in EDSS of more than 0.5 points, reflecting deterioration. Laboratory values were controlled for lymphopenia, renal and hepatic values, without any safety problems. We observed no significant differences between the two pharmaceutical forms. Conclusion: Our pilot data indicate that fumarate therapy appears to be safe and well tolerated by patients with progressive MS. In more than 75% of cases no further disease progression was evident. However, controlled studies are warranted to evaluate the detailed therapeutic potential of fumarates and their long-term effects in progressive MS.https://doi.org/10.1177/1756285614544466 |
| spellingShingle | Katrin Strassburger-Krogias Gisa Ellrichmann Christos Krogias Peter Altmeyer Andrew Chan Ralf Gold Fumarate treatment in progressive forms of multiple sclerosis: first results of a single-center observational study Therapeutic Advances in Neurological Disorders |
| title | Fumarate treatment in progressive forms of multiple sclerosis: first results of a single-center observational study |
| title_full | Fumarate treatment in progressive forms of multiple sclerosis: first results of a single-center observational study |
| title_fullStr | Fumarate treatment in progressive forms of multiple sclerosis: first results of a single-center observational study |
| title_full_unstemmed | Fumarate treatment in progressive forms of multiple sclerosis: first results of a single-center observational study |
| title_short | Fumarate treatment in progressive forms of multiple sclerosis: first results of a single-center observational study |
| title_sort | fumarate treatment in progressive forms of multiple sclerosis first results of a single center observational study |
| url | https://doi.org/10.1177/1756285614544466 |
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