Fever as the side effect of dimethyl fumarate – case report Case report
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Published:
Jun 30, 2018
Keywords:
multiple sclerosis, dimethyl fumarate, fever
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Abstract
Several new disease modifying therapies for treatment of multiple sclerosis (MS) have been registered lately. One of them is orally applied dimethyl fumarate (DMF). The drug’s efficacy was proved in treatment of relapsing-remitting MS, however DMF has some adverse effects. The most common of them are flushing and gastrointestinal disorders.
The article presents a case of the patient who experienced uncommon side effect: fever with worsening of neurological condition, during DMF dose escalation.
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References
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2. Ministerstwo Zdrowia. Program Lekowy: Leczenie stwardnienia rozsianego po niepowodzeniu terapii lekami pierwszego rzutu lub szybko rozwijającej się ciężkiej postaci stwardnienia rozsianego (ICD-10 G 35). In: 2017.
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6. Litjens N.H., van Strijen E., van Gulpen C. et al.: In vitro pharmacokinetics of anti-psoriatic fumaric acid esters. BMC Pharmacol. 2004; 4: 22.
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8. Linker R.A., Lee D.H., Ryan S. et al.: Fumaric acid esters exert neuroprotective effects in neuroinflammation via activation of the Nrf2 antioxidant pathway. Brain. 2011; 134(Pt 3): 678-692.
9. Scannevin R.H., Chollate S., Jung M.Y. et al.: Fumarates promote cytoprotection of central nervous system cells against oxidative stress via the nuclear factor (erythroid-derived 2)-like 2 pathway. J. Pharmacol. Exp. Ther. 2012; 341(1): 274-284.
10. Parodi B., Rossi S., Morando S. et al.: Fumarates modulate microglia activation through a novel HCAR2 signaling pathway and rescue synaptic dysregulation in inflamed CNS. Acta Neuropathol. 2015; 130(2): 279-295.
11. Chen H., Assmann J.C., Krenz A. et al.: Hydroxycarboxylic acid receptor 2 mediates dimethyl fumarate’s protective effect in EAE. J. Clin. Invest. 2014; 124(5): 2188-2192.
12. Lin S.X., Lisi L., Dello Russo C. et al.: The anti-inflammatory effects of dimethyl fumarate in astrocytes involve glutathione and haem oxygenase-1. ASN Neuro. 2011; 3(2).
13. Phillips J.T., Selmaj K., Gold R. et al.: Clinical Significance of Gastrointestinal and Flushing Events in Patients with Multiple Sclerosis Treated with Delayed-Release Dimethyl Fumarate. Int. J. MS Care 2015; 17(5): 236-243.
14. Sheikh S.I., Nestorov I., Russell H. et al.: Tolerability and pharmacokinetics of delayed-release dimethyl fumarate administered with and without aspirin in healthy volunteers. Clin. Ther. 2013; 35(10): 1582-1594.e1589.
15. Theodore Phillips J., Erwin A.A., Agrella S. et al.: Consensus Management of Gastrointestinal Events Associated with Delayed-Release Dimethyl Fumarate: A Delphi Study. Neurol. Ther. 2015; 4(2): 137-146.
2. Ministerstwo Zdrowia. Program Lekowy: Leczenie stwardnienia rozsianego po niepowodzeniu terapii lekami pierwszego rzutu lub szybko rozwijającej się ciężkiej postaci stwardnienia rozsianego (ICD-10 G 35). In: 2017.
3. Gold R., Kappos L., Arnold D.L. et al.: Placebo-controlled phase 3 study of oral BG-12 for relapsing multiple sclerosis. N. Engl. J. Med. 2012; 367(12): 1098-1107.
4. Fox R.J., Miller D.H., Phillips J.T. et al.: Placebo-controlled phase 3 study of oral BG-12 or glatiramer in multiple sclerosis. N. Engl. J. Med. 2012; 367(12): 1087-1097.
5. Havrdova E., Hutchinson M., Kurukulasuriya N.C. et al.: Oral BG-12 (dimethyl fumarate) for relapsing-remitting multiple sclerosis: a review of DEFINE and CONFIRM. Evaluation of: Gold R., Kappos L., Arnold D. et al.: Placebo-controlled phase 3 study of oral BG-12 for relapsing multiple sclerosis. N. Engl. J. Med. 2012; 367: 1098-1107; and Fox R.J., Miller D.H., Phillips J.T. et al.: Placebo-controlled phase 3 study of oral BG-12 or glatiramer in multiple sclerosis. N. Engl. J. Med. 2012; 367: 1087-1097. Expert Opin. Pharmacother. 2013; 14(15): 2145-2156.
6. Litjens N.H., van Strijen E., van Gulpen C. et al.: In vitro pharmacokinetics of anti-psoriatic fumaric acid esters. BMC Pharmacol. 2004; 4: 22.
7. Charakterystyka Produktu Leczniczego Tecfidera. 2014.
8. Linker R.A., Lee D.H., Ryan S. et al.: Fumaric acid esters exert neuroprotective effects in neuroinflammation via activation of the Nrf2 antioxidant pathway. Brain. 2011; 134(Pt 3): 678-692.
9. Scannevin R.H., Chollate S., Jung M.Y. et al.: Fumarates promote cytoprotection of central nervous system cells against oxidative stress via the nuclear factor (erythroid-derived 2)-like 2 pathway. J. Pharmacol. Exp. Ther. 2012; 341(1): 274-284.
10. Parodi B., Rossi S., Morando S. et al.: Fumarates modulate microglia activation through a novel HCAR2 signaling pathway and rescue synaptic dysregulation in inflamed CNS. Acta Neuropathol. 2015; 130(2): 279-295.
11. Chen H., Assmann J.C., Krenz A. et al.: Hydroxycarboxylic acid receptor 2 mediates dimethyl fumarate’s protective effect in EAE. J. Clin. Invest. 2014; 124(5): 2188-2192.
12. Lin S.X., Lisi L., Dello Russo C. et al.: The anti-inflammatory effects of dimethyl fumarate in astrocytes involve glutathione and haem oxygenase-1. ASN Neuro. 2011; 3(2).
13. Phillips J.T., Selmaj K., Gold R. et al.: Clinical Significance of Gastrointestinal and Flushing Events in Patients with Multiple Sclerosis Treated with Delayed-Release Dimethyl Fumarate. Int. J. MS Care 2015; 17(5): 236-243.
14. Sheikh S.I., Nestorov I., Russell H. et al.: Tolerability and pharmacokinetics of delayed-release dimethyl fumarate administered with and without aspirin in healthy volunteers. Clin. Ther. 2013; 35(10): 1582-1594.e1589.
15. Theodore Phillips J., Erwin A.A., Agrella S. et al.: Consensus Management of Gastrointestinal Events Associated with Delayed-Release Dimethyl Fumarate: A Delphi Study. Neurol. Ther. 2015; 4(2): 137-146.