Dimethyl fumarate-induced changes in the MS lymphocyte repertoire: No need for subset monitoring

Slow-release dimethyl fumarate (DMF) is the most widely prescribed oral disease-modifying therapy (DMT) for relapsing-remitting multiple sclerosis (RRMS). Class I evidence indicates that DMF reduces relapse rates, MRI disease activity, and, to a lesser extent, disability progression in RRMS.1,2 Apart from flushing, gastrointestinal symptoms, and (infrequently severe) lymphopenia, the drug is well-tolerated. Real-world comparison of oral DMTs showed slightly variable results, but suggest that DMF is roughly similar in reducing relapses compared to other oral DMTs, that is, fingolimod and teriflunomide,3 especially when used in naive patients.4

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