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Home arrow Environment arrow Inflammatory Disorders of the Nervous System: Pathogenesis, Immunology, and Clinical Management
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Tecfidera

One of the most recently approved drugs for treating MS is dimethyl fumarate (DMF), known commercially as Tecfidera (Biogen). DMF is a fumaric acid derivative originally used as a sensitizing agent to increase hypoxic tumor cell response to radiation, which has now been applied in the setting of MS. DMF, is a highly potent inhibitor of the transcription factor NF-kB [109]. By interfering with NF-kB-dependent mobilization of endothelial cell adhesion molecules, cytokines, and cytokine responses, DMF can block several essential CEC responses to inflammatory cytokines which support the BBB penetration of inflammatory immune cells [110, 111]. While highly effective, Tecfidera also has some clinical limitations associated with immune suppression (as has been described for Tysabri™/natalizumab) [112]. As of the time of this writing, several cases of PML have been reported in individuals using Tecfidera (four cases as of November 2015), and the use of this agent may need to be further supervised.

 
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