Neurológia pre prax 4/2014

Dimethyl-fumarate in treating relapsing-remitting multiple sclerosis

Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system (CNS), with neurodegeneration occurring from the very onset of the disease. With timely treatment, it is possible to slow down the whole immunopathological process. Therefore, treatment is best initiated at the first sign of disease or in the stage of relapsing-remitting MS (RRMS). In such a case, first-choice drugs are used (disease-modifying drugs – DMD). Escalation is required in patients with an insufficient effect of this treatment. For this purpose, either intravenous natalizumab or oral fingolimod are available. So far, none of the above-mentioned drugs has been shown to provide the optimal combination of efficacy with good tolerance and safety while targeting both the inflammation and the process of neurodegeneration. Dimethyl-fumarate (Tecfidera®), which was registered for the treatment of RRMS in the EU on 3rd February 2014, seems to meet these requirements most closely. The results of the ongoing postregistered clinical trials confirm if the dimethyl fumarate is anticipated to have the potential to be classified as the drug of first choice in patients with RRMS.

Keywords: multiple sclerosis, neurodegeneration, neuroprotection, dimethyl fumarate, BG-12, first-choice drugs, DMD.