In addition to its recognized anti-inflammatory effects, dimethyl fumarate also produces antioxidative effects that may be neuroprotective.
This article was originally published on the Specialty Pharmacy Times website.
Multiple sclerosis (MS) is an autoimmune disease. Although the full pathophysiology of MS is not completely understood, immunomodulatory agents (eg, beta-interferons, glatiramer acetate, steroids) have been used to reduce the risk of relapses, reduce the immune response associated with the condition, and improve quality of life in patients with MS. An early immunomodulatory medication, fumaric acid, is used as a counterion in many medications, and compounds related to fumaric acid have a long history of use in the treatment of psoriasis, which (like MS) is an autoimmune disorder. Not only are fumarate esters (FAEs) orally bioavailable, but the long history of use of FAEs (dating back to the late 1950s), and some evidence of neuroprotective effects, make these agents desirable options for patients seeking a long-term maintenance treatment for MS.
FAEs exert several pharmacologic effects, including induction of T-cell apoptosis and reduction of CD4+ and CD8+ lymphocyte levels. A specific FAE, dimethyl fumarate (DMF), also inhibits cytokine formation, which partially explains the anti-inflammatory effect of DMF. Beyond its anti-inflammatory effect, however, DMF also induces antioxidative effects. Some researchers believe that the antioxidative effects induced by DMF may be neuroprotective.
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