Abstract:

Objective: In this study, we aimed to obtain efficacy and safety data in relapsing multiple sclerosis (MS) patients who used dimethyl fumarate (DMF). Methods: The study was designed as an observational retrospective cohort study. The data of relapsing MS patients who were followed up in the Neurology Department of İstanbul Faculty of Medicine and used DMF between 2014 and 2021 were analyzed. The first EDSS (expanded disability status scale) worsening time, first relapse time, and first new MRI lesion time information was obtained after the onset of DMF, and no evidence of disease activity (NEDA-3) status was determined. Results: A total of 126 MS patients (85 females, 41 males; 116 RRMS, 10 RPMS) were included in the study. DMF was discontinued at a higher rate in patients who used another treatment before DMF, who were progressive with relapse, and who had a longer duration of disease before DMF (p=0.002, p=0.03, and p=0.002). Of the 65 patients diagnosed with RRMS and RPMS with brain MRI data, 25% of them maintained NEDA-3 status during the follow-up period after DMF initiation. However, an EDSS score below three before DMF onset significantly prolonged the time to loss of NEDA-3 status, first attack, and first disability accumulation (p=0.008 for NEDA-3, HR=1.95). Conclusion: The real-life data obtained in our study show a great deal of similarity with the current information. Our findings indicate that if DMF is started in patients with an EDSS score below 3, the risk of developing attacks, new lesions on brain MRI, and disability accumulation is reduced.

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