Dimethylfumarat in der therapie der schubförmigen MS: Verträglichkeit und management von nebenwirkungen

Until recently, disease modifying platform therapies for relapsing-remitting multiple sclerosis (MS) were limited to injectable drugs. With the introduced dimethylfumarate (DMF, Tecfidera®) an oral first-line MS therapy became available. In clinical phase III studies, DMF showed good efficacy and safety. Oral application may facilitate the integration of treatment in the everyday routine of patients, thereby potentially increasing treatment adherence. DMF was well tolerated in the clinical trials. Treatment discontinuations due to adverse events were infrequent. Side-effects, for instance gastrointestinal symptoms and flush, remained mostly mild to moderate; their incidence was highest in the first 1 to 3 months after treatment initiation and decreased thereafter. Reduced initial dosage, intake with food, usual symptomatic medications, acetylsalicylic acid as premedication (temporary), and optional temporary dose reduction may reduce these symptoms. These measures may help affected patients to bridge the initial treatment phase, thus enabling consistent long term therapy with this highly promising MS medication.