Search

Dimethyl fumarate is a third oral therapy approved for the treatment of relapsing-remitting multiple sclerosis. Dimethyl fumarate and fumaric acid esters have been well known for many years as they are effective for the treatment of psoriasis. However, only a few years ago, two Phase III clinical trials have shown that dimethyl fumarate is also effective and safe in the treatment of relapsing-remitting multiple sclerosis. Since 2016, treatment with dimethyl fumarate is also available and compensated for patients in Lithuania. The drug is used to treat patients with first line treatment ineffective enough, contraindicated, or when side effects appear to first line treatment. The article presents the mechanism of action of dimethyl fumarate, its efficacy and safety in clinical trials and its place in a multiple sclerosis treatment algorithm. Patients treated with dimethyl fumarate at Vilnius university hospital Santaros klinikos and treatment appointment indications are reviewed; the efficacy and safety, as well as side effects of the drug that led to its discontinuation are evaluated. [ABSTRACT FROM AUTHOR]

Introduction. Fingolimod is orally administered therapy for relapsing forms of multiple sclerosis. Phase 2 and 3 trials of fingolimod treatment led to a significant reduction in clinical and magnetic resonance imaging measures of disease activity compared to placebo or interferon beta-1a. Aim of the study. To assess relapse rate and disability progression in patients with highly active multiple sclerosis treated with fingolimod in Vilnius Multiple Sclerosis center. Materials and methods. 92 patients with highly active multiple sclerosis were included in the study. All patients were treated with fingolimod in Vilnius Multiple Sclerosis center in March 2017. Relapse rate was assessed two years before and during treatment with fingolimod. The EDSS was assessed two years before starting fingolimod, during the first dose of fingolimod and during the last visit in MS center. Results. 98.9% of patients were pre-treated with other disease modifying drugs. Mean duration of fingolimod treatment for all patients was 16.7±12.2 mths; for those who were treated more than 12 mths, mean duration was 23.7±11.0 mths. Relapse rate during two years was significantly higher in patients receiving first-line treatment than in fingolimod treatment - 2.2±0.9 and O. 6±0.8 retapses respectively (p<0.001). Mean EDSS deteriot rated by 0.99±0.81 points in patients receivmg first-line treatment and by 0.13±0.41 points in fingolimod treatment (p<0.05). Disability progression was significantly higher in patients with higher retapse rate receivmg first-line treatment for two years (r=-0.29, p=0.033), while in patients on fingolimod treatment this relation was not significant (p>0.05). Conclusions. Retapse rate and disabiltty progression were significantly lower in patients on fingolimod treatment than in patients receiving first line therapy, as assessed in two-year period. [ABSTRACT FROM AUTHOR]