Dimethyl fumarate - new measures to minimise leukoencephalopathy risk

Revised monitoring recommendations have been issued to reduce the risk of progressive multifocal leukoencephalopathy (PML) in patients with MS receiving dimethyl fumarate (Tecfidera).

Further information
View dimethyl fumarate drug record
Letter to healthcare professionals

A full blood count is now required every 3 months during treatment with dimethyl fumarate, and a baseline reference MRI should be performed before starting treatment.

If lymphocyte counts fall below 0.5 x109/L for more than 6 months, interruption of treatment should be considered. If treatment is stopped, patients should be monitored until lymphocyte levels return to normal. If treatment is continued, patients should be reminded to report symptoms of PML and the need for additional MRI should be considered. Treatment should be stopped immediately if PML is suspected.

PML is a rare but serious opportunistic infection caused by the John-Cunningham virus. Recommendations to reduce the risk of PML associated with dimethyl fumarate were initially introduced in April 2015 after a single fatal case was reported in a patient who had been receiving the drug for 4.5 years.

Want news like this straight to your inbox?
Sign up for our bulletins

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register
Already registered?
Sign in

MIMS Product Slides

Product overviews prepared by the MIMS team, in a handy slide format.

Click here

Slides are initiated, funded & reviewed by the companies specified.

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

MIMS Adviser

Especially created for prescribing influencers.

Request free copy

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases