dimethyl fumarate may be neuroprotective

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dimethyl fumarate may be neuroprotective

Postby frodo » Tue Jan 09, 2018 6:01 am

Effect of dimethyl fumarate on gray and white matter pathology in subjects with relapsing multiple sclerosis: a longitudinal study

http://onlinelibrary.wiley.com/doi/10.1 ... 13562/full

Abstract
Background

Dimethyl fumarate (DMF) is an oral treatment for relapsing remitting multiple sclerosis (RRMS) with anti-inflammatory and possible neuroprotective properties. Its effect on white matter (WM) and gray matter (GM) pathology is still not fully understood.
Objective

To characterize the effect of DMF on normal appearing WM (NAWM) and thalamic pathology longitudinally.
Methods

In this observational, longitudinal, 24-month MRI study, 75 RRMS treated with DMF and 40 age- and sex- matched healthy individuals (HIs) were enrolled. Regional diffusion tensor imaging (DTI) metrics and tract based spatial statistics (TBSS) analyses were used to assess differences between groups. Mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD) and fractional anisotropy (FA) were measured in the thalamus and NAWM. Baseline differences and changes over time were evaluated within and between study groups.
Results

At baseline, MS patients showed significantly increased diffusivity and decreased FA in the thalamus (p<0.001 for MD, AD and RD) and NAWM (all p <0.016) compared to HIs. No significant within-group difference was found in DTI measures over 24 months, in either group. HIs showed a significantly greater rate of increased diffusivity parameters in the thalamus and NAWM, compared to MS patients, over 24 months (p<0.05).
Conclusions

The lack of changes in DTI metrics in MS patients over 24 months possibly indicates a neuroprotective role of DMF. These findings provide additional evidence of the beneficial effect of DMF on MS-related pathology.
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Re: dimethyl fumarate may be neuroprotective

Postby koneall » Tue Jan 09, 2018 11:17 am

Does it differ from clemastine fumarate?
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Re: dimethyl fumarate may be neuroprotective

Postby Scott1 » Tue Jan 09, 2018 2:21 pm

Hi,

The clemastine fumarate is an anti histamine. It binds to a specific receptor to block the histamine cascade. It can have side effects if used excessively. It also blocks the neurotransmitter aceytlcholine. I'm genuinely not sure if that's a good thing or not. I'd like to think it can be useful but the long term effect of that is unknown.

Like other antihistamines, it can be sedating and drying. Overdosing can cause hallucinations and other symptoms (see toxicity here- https://www.drugbank.ca/drugs/DB00283 )

Dimethyl fumarate is sold under the brand name Tecfidera. The FDA has noted that it can cause the fatal condition PML. Some years ago, after I was hospitalised, I was given Tecfedira. After a month I'd had two visits from the ambulance and one trip back to hospital with a query heart attack (wasn't but not fun). That could have been due to either contraindications with other medication, a genetic susceptibilty or just a failure to pay attention to the manufacturers note. Needless to say, I didn't continue with it.

Both these products are man made compounds . Fumarate is an intermediate in the citric acid cycle and that's probably the right place to be looking. However, what happens at each stage depends on the enzymes (that end in 'ase'). I don't think it would be a case of saying similar names do similar things.
It's worth looking up the FDA notes on a lot of MS drugs. You will quickly see how little they know about how most of them work.

Regards
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