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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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