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   DIR Return to: TECFIDERA (dimethyl fumarate, BG-12, Fumaderm)
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       #Post#: 303--------------------------------------------------
       (AAN) Transient neurologic worsening after starting Tecfidera in
       progressive MS
   DIR By: agate
       Date: May 9, 2014, 3:36 pm
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       Presented as a poster session at the AAN annual conference in
       Philadelphia, April 29, 2014:
       --- Quote ---
       > [P2.228] Transient Neurologic Worsening after Initiation of
       Dimethyl Fumarate Therapy in Progressive Multiple Sclerosis
       Patients
       >
       > James Stark, Sydney Chirls, Saud Sadiq
       >
       > New York, NY, USA
       >
       > OBJECTIVE:
       >
       > To describe a syndrome of neurologic worsening after
       initiation of dimethyl fumarate in patients with progressive
       forms of MS.
       >
       > BACKGROUND:
       >
       > Dimethyl fumarate (DMF) was recently approved for the
       treatment of relapsing forms of multiple sclerosis. Given its
       novel mechanism of action, there has been considerable interest
       in the study of DMF in patients with progressive forms of MS, as
       treatment options are limited. We used DMF for progressive MS as
       an off label agent.
       >
       > DESIGN/METHODS:
       >
       > This is a retrospective chart review at a single MS center of
       patients who initiated treatment with DMF. All patients gave an
       informed consent and the study is IRB approved.
       >
       > RESULTS:
       >
       > All progressive disease MS patients at our center who were not
       on other disease modifying therapy and consented to take DMF
       were included in the analysis. We identified 14 of 259
       (5%)patients who following initiation of DMF treatment developed
       acute neurologic worsening. Ten of the 14 patients had secondary
       progressive MS and 4 had primary progressive. Eleven of the 14
       patients (78%) were female with a mean age of 52 years (range
       41-61), and patients had a mean disease duration of 19.7 years
       (range 10-30). The EDSS ranged from 3.5 to 8.5 (mean 6.3). The
       duration of DMF treatment before the onset of worsening
       neurologic symptoms was variable (1-42 days). The most common
       neurologic complaint was increased motor weakness.
       >
       > All patients returned to baseline neurologic status after
       discontinuation of DMF, generally within a few days.
       >
       > CONCLUSIONS:
       >
       > Patients with progressive forms of MS may experience a
       transient worsening of neurologic function following initiation
       of therapy with DMF. This effect appears independent of the
       subtype of progressive disease and not related to the well
       described adverse effects associated with DMF therapy. It is
       likely that this worsening is caused by a conduction block as it
       reverses with cessation of treatment.
       >
       > Study Supported by:
       >
       > None.
       > Category - MS and CNS Inflammatory Disease: Clinical Science
       >
       >
       >
       > P2: Poster Session II: MS and CNS Inflammatory Disease:
       Treatment Safety
       >
       --- End Quote ---
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