Effect of dimethyl fumarate on lymphocyte subsets in patients with relapsing multiple sclerosis
| Autor: | Claudia Prada, Mariko Kita, Pavle Repovic, Daniel S. Bandari, Emily Riser, Bhupendra O. Khatri, Sherrill Loring, Jeffrey Greenstein, Nick Everage, Guy J. Buckle, Katherine Riester, Mark Gudesblatt, Irene Koulinska, Bianca Weinstock-Guttman, Ben Thrower, Monica Mann |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
T-cell subsets Multiple sclerosis 03 medical and health sciences Cellular and Molecular Neuroscience chemistry.chemical_compound natalizumab 0302 clinical medicine Natalizumab Medicine In patient dimethyl fumarate Dimethyl fumarate business.industry Absolute lymphocyte count medicine.disease Original Research Paper absolute lymphocyte count 030104 developmental biology chemistry Immunology Neurology (clinical) business 030217 neurology & neurosurgery Lymphocyte subsets medicine.drug |
| Zdroj: | Multiple Sclerosis Journal-Experimental, Translational and Clinical |
| ISSN: | 2055-2173 |
| DOI: | 10.1177/2055217320918619 |
| Popis: | Background In patients treated with dimethyl fumarate, absolute lymphocyte count decline typically occurs during the first year and then plateaus; early drops have been associated with the development of severe prolonged lymphopenia. Objective We investigated the effect of dimethyl fumarate on absolute lymphocyte counts and CD4+/CD8+ T cells in patients with relapsing–remitting multiple sclerosis treated with dimethyl fumarate in routine practice. Methods Lymphocyte data were collected via medical chart abstraction. Primary endpoint: change from baseline in absolute lymphocyte count and CD4+/CD8+ counts at 6‐month intervals following dimethyl fumarate initiation. Results Charts of 483 patients were abstracted and 476 patients included in the analysis. Mean baseline absolute lymphocyte count (2.23 × 109/l) decreased by ∼39% (95% confidence interval: –41.1 to –37.2) by month 6 and 44% (95% confidence interval: –46.6 to –42.1) by month 12. CD4+ and CD8+ T-cell subsets strongly correlated with absolute lymphocyte count, with greater decreases from baseline to 6 months vs 6–12 months, and in CD8+ vs CD4+ T cells. Prior natalizumab was not a risk factor for lymphopenia. Conclusion Dimethyl fumarate-associated decline in absolute lymphocyte count in the first 12 months correlated with decline in CD4+ and CD8+ T cells and was independent of prior natalizumab. Absolute lymphocyte count monitoring continues to be an effective strategy to identify patients at risk of prolonged lymphopenia. |
| Databáze: | OpenAIRE |
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