Dimethyl Fumarate for Pediatric-Onset Multiple Sclerosis: A Systematic Review

Dimethyl fumarate (DMF) is an oral disease-modifying therapy (DMT) being used for adult patients with multiple sclerosis (MS) with acceptable safety and efficacy profile. The use of DMF for pediatric-onset multiple sclerosis (POMS) is being considered especially for patients who prefer a self-administered oral DMT. To systematically review the experience with DMF in POMS regarding the safety and efficacy profile.

This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three different databases were searched (PubMed, Scopus, and Web of Science) to find relevant articles until the end of May 15, 2024. Data were screened and extracted by two independent authors.

From 344 studies, six studies with 316 patients were included in the systematic review. DMF had an acceptable effect on reducing relapses and magnetic resonance imaging activity. Gastrointestinal discomfort and facial flushing were the most reported adverse events related to the use of DMF in patients with POMS.

DMF could be considered for patients with POMS both as first-line and switching therapy. Despite a recent tendency toward high-efficacy DMTs for POMS, DMF remains a good option for certain cases.