Worsening of lymphopenia in patients with multiple sclerosis when switched from dimethyl fumarate to diroximel fumarate.

Autor: Dempsey JP; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Wu L; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Balshi A; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Jun C; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Baber U; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Sloane JA; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. Electronic address: jsloane@bidmc.harvard.edu.
Jazyk: angličtina
Zdroj: Multiple sclerosis and related disorders [Mult Scler Relat Disord] 2024 Sep; Vol. 89, pp. 105737. Date of Electronic Publication: 2024 Jun 27.
DOI: 10.1016/j.msard.2024.105737
Abstrakt: Background: Diroximel fumarate (DRF) and dimethyl fumarate (DMF) are similar disease-modifying therapies (DMTs) that reduce disease activity in patients with relapsing-remitting multiple sclerosis (MS). We expect that patients on DRF would experience a similar incidence and severity of lymphopenia, given that it is a well-documented side effect of DMF treatment.
Methods: We utilized linear mixed-effects models to test for differences in white blood cell count (WBC), absolute lymphocyte count (ALC), absolute CD3+ count, absolute CD4+ count, and absolute CD8+ count over time in clinically stable patients with MS on DMF who switched to DRF.
Results: Twenty-two patients with MS who were clinically stable on DMF switched to DRF. Linear mixed-effects models showed a decrease in ALC when switching medications (β = -225.70, p < 0.040). In addition, the models showed a decrease in absolute CD8+ counts after switches from DMF to DRF (β = -85.59, p = 0.034).
Conclusion: Patients with MS who are stable on DMF and switch to DRF may experience worsening of lymphopenia and lower absolute CD8+ counts, which may increase their risk of opportunistic infections. These findings indicate that close lymphocyte subset monitoring is clinically important when switching patients with MS from DMF to DRF.
Competing Interests: Declaration of competing interest We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled, “Worsening of lymphopenia in patients with multiple sclerosis when switched from dimethyl fumarate to diroximel fumarate.”
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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