Contributions
Abstract: P1236
Type: Poster
Abstract Category: Therapy - disease modifying - Long-term treatment monitoring
Background: Dimethyl fumarate (DMF) is an effective oral therapy for relapsing remitting multiple sclerosis with different biological effects on immunomodulation and neuroprotection.
Objectives: To analyse the impact of DMF therapy on blood counts in a group of patients treated over a 12 month period.
Methods: 106 patients were included in the study, 70% females, with a mean EDSS of 1.41. EDSS, number of relapses and adverse events were recorded every 3 months. Complete blood count (CBC), biochemical tests and urinanalysis were performed at months 1,2,3,6,9 and 12.
Results: 57% of patients developed lymphopenia: 67% mild (1300-800/uL), 21% moderate (800-500/uL) and 6% severe (< 500/uL) lymphopenia. Different patterns of lymphopenia were observed: progressive 8.4%, persistent 33% and transient 17%. There was no relation between those patterns and previous treatments. A striking finding was the frequent (24.5%) presence of eosinophilia, detected most often in the first month of therapy (80% of cases), with values ranging 500-5.300/uL. Eosinophilia was asymptomatic in all but one, and disappeared in 91% after 2 months. Treatment had to be withdrawn in 2 patients: in one case due to progressive severe lymphopenia and because of eosinophilia with urticaria in another patient. Compared to the rest of patients, those who developed early eosinophilia had an increased tendency to suffer lymphopenia more frequently.
Conclusions: DMF has a good tolerability profile. However, a significant percentage of patients develop lymphopenia. Different grades and patterns of lymphopenia have been observed in our series. In addition, eosinophilia, an observation generally unnoticed due to its early presentation, has been observed in a quarter of patients. The meaning of these observation is unclear. We could not establish a significant relation neither between eosinophilia and lymphopenia nor between previous treatments and the development of blood count disturbances. Clinical vigilance and periodic blood tests are mandatory.
Disclosure: A. García Merino has received compensation for travel expenses, speaking honoraria and consultation fees from Bayer, Merck, Teva, Biogen Idec, Novartis, Roche, Almirall, Sanofi-Aventis and Genzyme. M.R. Blasco Quílez, I. Moreno Torres, L. Mena Romo, S. Novo Ponte, C. García Malo and A. Vinagre Aragón: nothing to disclose.
Abstract: P1236
Type: Poster
Abstract Category: Therapy - disease modifying - Long-term treatment monitoring
Background: Dimethyl fumarate (DMF) is an effective oral therapy for relapsing remitting multiple sclerosis with different biological effects on immunomodulation and neuroprotection.
Objectives: To analyse the impact of DMF therapy on blood counts in a group of patients treated over a 12 month period.
Methods: 106 patients were included in the study, 70% females, with a mean EDSS of 1.41. EDSS, number of relapses and adverse events were recorded every 3 months. Complete blood count (CBC), biochemical tests and urinanalysis were performed at months 1,2,3,6,9 and 12.
Results: 57% of patients developed lymphopenia: 67% mild (1300-800/uL), 21% moderate (800-500/uL) and 6% severe (< 500/uL) lymphopenia. Different patterns of lymphopenia were observed: progressive 8.4%, persistent 33% and transient 17%. There was no relation between those patterns and previous treatments. A striking finding was the frequent (24.5%) presence of eosinophilia, detected most often in the first month of therapy (80% of cases), with values ranging 500-5.300/uL. Eosinophilia was asymptomatic in all but one, and disappeared in 91% after 2 months. Treatment had to be withdrawn in 2 patients: in one case due to progressive severe lymphopenia and because of eosinophilia with urticaria in another patient. Compared to the rest of patients, those who developed early eosinophilia had an increased tendency to suffer lymphopenia more frequently.
Conclusions: DMF has a good tolerability profile. However, a significant percentage of patients develop lymphopenia. Different grades and patterns of lymphopenia have been observed in our series. In addition, eosinophilia, an observation generally unnoticed due to its early presentation, has been observed in a quarter of patients. The meaning of these observation is unclear. We could not establish a significant relation neither between eosinophilia and lymphopenia nor between previous treatments and the development of blood count disturbances. Clinical vigilance and periodic blood tests are mandatory.
Disclosure: A. García Merino has received compensation for travel expenses, speaking honoraria and consultation fees from Bayer, Merck, Teva, Biogen Idec, Novartis, Roche, Almirall, Sanofi-Aventis and Genzyme. M.R. Blasco Quílez, I. Moreno Torres, L. Mena Romo, S. Novo Ponte, C. García Malo and A. Vinagre Aragón: nothing to disclose.