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#Post#: 447--------------------------------------------------
(Abst.) Fumarate treatment in progressive MS
By: agate Date: August 27, 2014, 4:18 pm
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From Therapeutic Advances in Neurological Disorders, August 19,
2014:
[quote]Fumarate treatment in progressive forms of multiple
sclerosis: first results of a single-center observational study
Katrin Strassburger-Krogias
Department of Neurology, Ruhr University Bochum, St
Josef-Hospital, Bochum, Germany
Gisa Ellrichmann
Department of Neurology, Ruhr University Bochum, St
Josef-Hospital, Bochum, Germany
Christos Krogias
Department of Neurology, Ruhr University Bochum, St
Josef-Hospital, Bochum, Germany
Peter Altmeyer
Department of Dermatology, Ruhr University Bochum, St
Josef-Hospital, Bochum, Germany
Andrew Chan
Department of Neurology, Ruhr University Bochum, St
Josef-Hospital, Bochum, Germany
Ralf Gold
Department of Neurology, Ruhr University Bochum, St
Josef-Hospital, Gudrunstraße 56, 44791 Bochum, Germany
ralf.gold@rub.de
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.[/quote]
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