Long-term disease stabilization and neurological improvement in a relapsing-remitting multiple sclerosis patient treated de novo with dimethyl fumarate – case report Case report
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Published:
Mar 31, 2024
Keywords:
multiple sclerosis, relapsing-remitting multiple sclerosis, dimethyl fumarate, disease-modifying therapy, lymphopenia
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Abstract
In this paper a case study is presented, regarding a 37-year-old male with relapsing-remitting multiple sclerosis, in whom long-term disease stabilization, no evidence of disease activity and neurological improvement was achieved with the use of oral dimethyl fumarate. The most recent real-world data regarding efficacy and safety of dimethyl fumarate in multiple sclerosis patients are discussed, alongside risk factors, monitoring, and the course of lymphopenia in multiple sclerosis patients treated with dimethyl fumarate.
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References
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5. Pandey K, Giles K, Balashov K et al. Long-Term Safety and Effectiveness of Delayed-release Dimethyl Fumarate in Multiple Sclerosis Patients Treated in Routine Medical Practice. Poster: P7.4-009, presented at: American Academy of Neurology (AAN) – 74th Annual Meeting 2022.
6. Fox RJ, Chan A, Gold R et al. Characterizing absolute lymphocyte count profiles in dimethyl fumarate-treated patients with MS: patient management considerations. Neurol Clin Pract. 2016; 6: 220-9.
7. Mehta D, Miller C, Arnold DL et al. Effect of dimethyl fumarate on lymphocytes in RRMS: implications for clinical practice. Neurology. 2019; 92: e1724-e1738.
8. Fox RJ, Chan A, Gold R et al. Lymphocyte decline and reconstitution after discontinuation in patients with severe, prolonged lymphopenia treated with delayed-release dimethyl fumarate. Poster: P5.366, presented at American Academy of Neurology (AAN), 21-27.04.2018, LA, USA.
9. Baeva ME, Metz LM, Greenfield J et al. Simple parameters from complete blood count predict lymphopenia, adverse effects and efficacy in people with MS treated with dimethyl fumarate. Mult Scler Relat Disord. 2023; 74: 104699.
10. Ravn J, Jensen HB, Kant M et al. Risk factors for development of lymphopenia in dimethyl fumarate-treated patients with multiple sclerosis. Mult Scler Relat Disord. 2022; 67: 104081.
11. Diebold M, Galli E, Kopf A et al. Immunological Predictors of Dimethyl Fumarate-Induced Lymphopenia. Ann Neurol. 2022; 91(5): 676-81.
12. Newman S et al. A Retrospective Chart Review of Lymphocyte Reconstitution Among MS Patients After Discontinuation of Dimethyl Fumarate. Poster no 226, presented at Virtual AAN Annual Meeting; April 17–22, 2021.
13. Berglund A, Forsberg L, Piehl F et al. Lymphocyte reconstitution following discontinuation of dimethyl fumarate (dmf) due to lymphopenia in the swedish post-market surveillance study imse-5. Poster P0351, presented at 8th Joint ACTRIMS-ECTRIMS Virtual Meeting; September 9–12, 2020.
14. Chan A, Rose J, Alvarez E et al. Lymphocyte reconstitution after DMF discontinuation in clinical trial and real-world patients with MS. Neurol Clin Pract. 2020; 10(6): 510-9.
2. Rotstein D, Montalban X. Reaching an evidence-based prognosis for personalized treatment of multiple sclerosis. Nat Rev Neurol. 2019; 15(5): 287-300.
3. Kułakowska A, Mirowska-Guzel D, Kalinowska A et al. Leczenie modyfikujące przebieg stwardnienia rozsianego. Rekomendacje Sekcji Stwardnienia Rozsianego i Neuroimmunologii Polskiego Towarzystwa Neurologicznego. Polski Przegląd Neurologiczny. 2023; 3(19): 163-89.
4. Thompson AJ, Banwell BL, Barkhof F et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018; 17(2): 162-73.
5. Pandey K, Giles K, Balashov K et al. Long-Term Safety and Effectiveness of Delayed-release Dimethyl Fumarate in Multiple Sclerosis Patients Treated in Routine Medical Practice. Poster: P7.4-009, presented at: American Academy of Neurology (AAN) – 74th Annual Meeting 2022.
6. Fox RJ, Chan A, Gold R et al. Characterizing absolute lymphocyte count profiles in dimethyl fumarate-treated patients with MS: patient management considerations. Neurol Clin Pract. 2016; 6: 220-9.
7. Mehta D, Miller C, Arnold DL et al. Effect of dimethyl fumarate on lymphocytes in RRMS: implications for clinical practice. Neurology. 2019; 92: e1724-e1738.
8. Fox RJ, Chan A, Gold R et al. Lymphocyte decline and reconstitution after discontinuation in patients with severe, prolonged lymphopenia treated with delayed-release dimethyl fumarate. Poster: P5.366, presented at American Academy of Neurology (AAN), 21-27.04.2018, LA, USA.
9. Baeva ME, Metz LM, Greenfield J et al. Simple parameters from complete blood count predict lymphopenia, adverse effects and efficacy in people with MS treated with dimethyl fumarate. Mult Scler Relat Disord. 2023; 74: 104699.
10. Ravn J, Jensen HB, Kant M et al. Risk factors for development of lymphopenia in dimethyl fumarate-treated patients with multiple sclerosis. Mult Scler Relat Disord. 2022; 67: 104081.
11. Diebold M, Galli E, Kopf A et al. Immunological Predictors of Dimethyl Fumarate-Induced Lymphopenia. Ann Neurol. 2022; 91(5): 676-81.
12. Newman S et al. A Retrospective Chart Review of Lymphocyte Reconstitution Among MS Patients After Discontinuation of Dimethyl Fumarate. Poster no 226, presented at Virtual AAN Annual Meeting; April 17–22, 2021.
13. Berglund A, Forsberg L, Piehl F et al. Lymphocyte reconstitution following discontinuation of dimethyl fumarate (dmf) due to lymphopenia in the swedish post-market surveillance study imse-5. Poster P0351, presented at 8th Joint ACTRIMS-ECTRIMS Virtual Meeting; September 9–12, 2020.
14. Chan A, Rose J, Alvarez E et al. Lymphocyte reconstitution after DMF discontinuation in clinical trial and real-world patients with MS. Neurol Clin Pract. 2020; 10(6): 510-9.