PMID- 32607065
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220415
IS  - 1537-2073 (Print)
IS  - 1537-2073 (Linking)
VI  - 19
IP  - 2
DP  - 2017 Mar-Apr
TI  - Dimethyl Fumarate: A Review of Efficacy and Practical Management Strategies for 
      Common Adverse Events in Patients with Multiple Sclerosis.
PG  - 74-83
LID - 10.7224/1537-2073.2015-086 [doi]
AB  - BACKGROUND: Delayed-release dimethyl fumarate (DMF; also known as gastroresistant 
      DMF) is indicated for the treatment of relapsing multiple sclerosis. Flushing and 
      gastrointestinal (GI) adverse events (AEs) are common within the first few months 
      of starting DMF therapy. Although most symptoms are mild or moderate in severity, 
      transient, and infrequently result in treatment discontinuation, they 
      nevertheless present a challenge for patients to adhere to therapy and achieve an 
      optimal treatment response. METHODS: This review discusses management strategies 
      for the prophylaxis and treatment of common DMF-associated AEs based on clinical 
      trial evidence and real-world experience in clinical practice settings. RESULTS: 
      Before starting DMF therapy, patients should receive counseling on the importance 
      of treatment adherence and the likely occurrence and severity of flushing and GI 
      AEs (nausea, vomiting, diarrhea, and abdominal pain). Management strategies, such 
      as administering DMF with food, using a slower-dose titration schedule, applying 
      temporary dose reductions, and using symptomatic therapies, provide clinicians 
      with several approaches to address DMF tolerability. In particular, DMF 
      coadministration with certain foods (eg, sausage, peanut butter) may prevent or 
      reduce the severity of GI AEs. Taking aspirin 325 mg/day 30 minutes before 
      administering DMF in the first month of therapy can reduce the incidence and 
      severity of flushing without negatively affecting GI-related events. CONCLUSIONS: 
      Through continual patient education and support and management of 
      treatment-related flushing and GI AEs, clinicians can help patients adhere to and 
      persist with DMF therapy, thus maximizing treatment benefit.
CI  - (c) 2017 Consortium of Multiple Sclerosis Centers.
FAU - Phillips, J Theodore
AU  - Phillips JT
FAU - Agrella, Stephanie
AU  - Agrella S
FAU - Fox, Robert J
AU  - Fox RJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Int J MS Care
JT  - International journal of MS care
JID - 101132980
PMC - PMC7313409
COIS- Financial Disclosures: Dr. Phillips has received consulting fees from Acorda, 
      Biogen, Genentech, Genzyme, Merck Serono, Sanofi-Aventis, and Xenoport. Ms. 
      Agrella has received consulting fees from Acorda, Biogen, Genzyme, Pfizer, 
      Serono, and Teva. Dr. Fox has received consulting fees from and been a member of 
      advisory committees for Actelion, Biogen, MedDay, Novartis, Questcor, Teva, and 
      Xenoport and has received research support from Novartis.
EDAT- 2017/03/01 00:00
MHDA- 2017/03/01 00:01
PMCR- 2017/03/01
CRDT- 2020/07/02 06:00
PHST- 2020/07/02 06:00 [entrez]
PHST- 2017/03/01 00:00 [pubmed]
PHST- 2017/03/01 00:01 [medline]
PHST- 2017/03/01 00:00 [pmc-release]
AID - 10.7224/1537-2073.2015-086 [doi]
PST - ppublish
SO  - Int J MS Care. 2017 Mar-Apr;19(2):74-83. doi: 10.7224/1537-2073.2015-086.