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Dimethyl Fumarate for Pediatric-Onset Multiple Sclerosis: A Systematic Review
Masoud Etemadifar1, Hasan Kaveyee1, Yasin Ebne-Ali-Heydari1
1School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
Insights
Dimethyl fumarate (DMF) is effective for pediatric multiple sclerosis (MS), reducing relapses and MRI activity. While gastrointestinal issues and flushing occur, DMF is a viable oral treatment option for pediatric-onset MS (POMS).
Area of Science:
- Neurology
- Pediatric Neurology
- Pharmacology
Background:
- Dimethyl fumarate (DMF) is an oral disease-modifying therapy (DMT) approved for adult multiple sclerosis (MS).
- Its use in pediatric-onset multiple sclerosis (POMS) is being explored, particularly for self-administered oral DMT preference.
- This review systematically assesses DMF's safety and efficacy in POMS.
Approach:
- A systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Searched PubMed, Scopus, and Web of Science databases for relevant studies up to May 15, 2024.
- Data extraction and screening performed by two independent authors.
Key Points:
- Six studies involving 316 patients with POMS were included.
- DMF demonstrated efficacy in reducing MS relapses and magnetic resonance imaging (MRI) activity.
- The most common adverse events were gastrointestinal discomfort and facial flushing.
Conclusions:
- DMF can be considered for POMS as both a first-line and switching therapy.
- Despite a trend towards high-efficacy DMTs, DMF remains a suitable option for select POMS cases.
- DMF offers an acceptable safety and efficacy profile for managing pediatric MS.
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