جستجوی مقالات مرتبط با کلیدواژه "dimethyl fumarate" در نشریات گروه "پزشکی"
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زمینه و هدف
مالتیپل اسکلروزیس یک اختلال سیستم ایمنی است که در ایران شیوع متوسطی دارد. با توجه به آن که پژوهش های مدونی در خصوص تعیین عوارض جانبی داروهای خوراکی مورد استفاده در این بیماری وجود ندارد، لذا هدف از این مطالعه تعیین و بررسی بروز عوارض جانبی داروهای خوراکی در درمان مبتلایان به بیماری مولتیپل اسکلروزیس عود کننده بهبود یابنده در کلینیک امام خمینی (ره) همدان بود.
روش بررسیدر این مطالعه مشاهده ای آینده نگر که در سال های 13971396 انجام شد، جمعیت مورد مطالعه بیماران مبتلا به ام اس عودکننده بهبودیابنده قطعی مراجعه کننده به بیمارستان امام خمینی (ره) بودند. 300 بیمار به طور تصادفی ساده در سه گروه درمانی دریافت کننده فینگولیمود، دی متیل فومارات و تریفلونومید قرار گرفتند. پاسخ به درمان در ابتدای ماه اول، سوم، ششم، دوازدهم و بیست و چهارم پس از شروع درمان ارزیابی شد. در نهایت فراوانی عوارض جانبی برای هر گروه مشخص و داده های جمع آوری شده در هر گروه درمانی مقایسه شدند. داده ها جمع آوری شده با استفاده از آزمون های آماری آنالیز واریانس تجزیه و تحلیل شدند.
یافته هاداده های حاصل از این مطالعه نشان داد که بیشترین عوارض بالینی شامل عوارض عصبی (8/21 درصد) و عوارض گوارشی (6/15 درصد) بود. بیشترین عوارض آزمایشگاهی شامل عوارض کبدی (9/12 درصد) و عوارض قلبی عروقی (3/10 درصد) بود. هم چنین کمترین عوارض بالینی شامل عوارض اسکلتی (6/4 درصد) و عوارض غدد درون ریز (3 درصد) و کمترین عوارض آزمایشگاهی ادم ماکولا (6/0 درصد) بود.
نتیجه گیریدر این مطالعه داروی فینگولیمود بیشترین عوارض جانبی و داروی تری فلونامید کمترین عوارض جانبی را داشت. دی متیل فومارات به دلیل شدت عوارض بیشتر قطع شد و تری فلونامید بیشتر ادامه پیدا کرد.
کلید واژگان: مالتیپل اسکلروزیس, فینگولیمود, تریفلونومید, دی متیل فومارات, مطالعه بالینی, عوارض جانبیArmaghane-danesh, Volume:29 Issue: 1, 2024, PP 112 -124Background & aimThree oral drugs, including fingolimod, dimethyl fumarate, and teriflunomide, which are clinically approved for the therapy of relapsing–remitting multiple sclerosis (RRMS) were reviewed in this work. The present study aimed to recognize the side effects of the oral drugs in RRMS patients who were consulted in neurology clinic in west of Iran.
MethodsThe study population of the present prospective observational study conducted in 2016-2017 were patients with relapsing-remitting MS referred to Imam Khomeini Hospital (RA). Three hundred patients with RRMS were randomly assigned to three treatment groups. The first group received fingolimod, the second group received dimethyl fumarate, and the third group received teriflunomide. The response to treatment assessed at 1, 3, 6, 12, and 24 months after the start of treatment. Eventually, the frequency of adverse effects characterized for each group and the collected data compared in each treatment group. The collected data were analyzed using ANOVA statistical tests.
ResultsThe findings of the present study revealed that the most common clinical complications were neurological (21.8%) and gastrointestinal complications (15.6%). The most common laboratory complications were liver (12.9%) and cardiovascular complications (10.3%). Moreover, the lowest clinical complications were musculoskeletal (4.6%) and endocrine complications (3%) and lowest laboratory complications were macular edema (0.6%).
ConclusionIn the present study, fingolimod had the most side effects and triflunomide had the least side effects. Dimethyl fumarate was stopped due to the severity of side effects and triflunomide was continued.
Keywords: Multiple sclerosis, Fingolimod, Teriflunomid, Dimethyl Fumarate, Clinical research, Adverse effects -
Background
Methotrexate (MTX), a folate antagonist used to treat cancer and inflammatory diseases, isknownto generate reactive oxygen species.
ObjectivesThe research investigates the impact of dimethyl fumarate (DMF), a nuclear factor erythroid 2-related factor 2 (Nrf2) activator, on an MTX-induced mouse hepatotoxicity model.
MethodsForty-two mice were divided into 6 groups: control, MTX, DMF 120, and 3 groups of MTX co-treated with DMF 30, 60, and 120 mg/kg. Dimethyl fumarate was gavaged once daily for 10 days. On the fifth day, the animals received MTX 20 mg/kg intraperitoneally. On the eleventh day, the animals were sacrificed, and serum and liver samples were collected to assess the level of oxidative/anti-oxidative and apoptotic/anti-apoptotic markers.
ResultsDimethyl fumarate prevented the increase of liver function enzymes, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) induced by MTX (P < 0.001). It prevented the increase in AST and ALT levels, indicating liver recovery (P < 0.001). Furthermore, DMF restored antioxidant markers superoxide dismutase, catalase, glutathione peroxidase, and total thiol while reducing the level of thiobarbituric acid reactive substances (P < 0.001). Dimethyl fumarate also downregulated hepatic mRNA expression of caspase 3 and upregulated Bcl-2, heme oxygenase 1, and Nrf2 genes in MTX co-treated DMF groups.
ConclusionsDimethyl fumarate alleviates oxidative stress and apoptosis, which may be achieved by the Nrf2/HO-1 pathway. Therefore, DMF may be clinically effective in preventing or treating MTX-induced hepatotoxicity.
Keywords: Methotrexate, Hepatotoxicity, Dimethyl Fumarate, Anti-oxidative, Anti-apoptotic -
Currently available disease modifying anti-rheumatoid drugs have limitations like dose-dependent toxicity and tolerance.Dimethyl fumarate has demonstrated anti-inflammatory and immunomodulatory properties in various animal models. Thus, thepresent study aimed to evaluate the effects and mechanism of DMF in a murine model of adjuvant-induced arthritis.A total of 84 rats were divided into early treatment groups (n=48) and late treatment groups (n=36). There were 8 subgroupsand 6 subgroups (n=6 in each group) in the early and late treatment groups, respectively. Experimental rheumatoid arthritis(RA) was induced in Wistar rats by injecting complete Freund's adjuvant (CFA) intradermally at the base of the tail. Antirheumatic effects were evaluated by arthritis and histopathological scoring of ankle joints. To evaluate anti-oxidant properties,GSH, catalase, SOD, and lipid peroxidation were measured. ESR, WBC count, TNF-α and IL-6 levels were measured to evaluatethe immunomodulatory properties of DMF. DMF demonstrated anti-inflammatory effects by decreasing arthritis andhistopathological scores compared to the CFA control group, though the difference was not statistically significant. DMFexhibited immunomodulatory properties as decreases in TLC count, serum TNF-α, and plasma IL-6 levels were observed. In allthe above-mentioned parameters, the best response was achieved with the early combination therapy of DMF 30 mg/kg andmethotrexate [Mtx] 0.1 mg/kg. In the present study, DMF demonstrated antirheumatoid effects in a rat model of CFA-inducedarthritis. The best antirheumatoid effect was achieved with the early combination of DMF and Mtx.
Keywords: anti-inflammatory agents, Antioxidants arthritis, Dimethyl fumarate, Freund's adjuvant, Rheumatoid -
Background
Cerebral ischemia is an important cause of morbidity and mortality worldwide. Dimethyl fumarate (DMF) is indicated for the treatment of patients with relapsing forms of Multiple Sclerosis and psoriasis.
ObjectivesIn this study, the effect of DMF on memory and learning impairments and nitrosative stress after cerebral ischemia in rats, was evaluated.
MethodsCerebral ischemia was induced via common carotid artery occlusion (CCAO). Rats were randomly divided into three groups (N = 5). Group I included Sham-operated animals who underwent surgery without arterial occlusions, group II (control ischemic) underwent surgery to induce transient global cerebral ischemia for 20 min and received 0.2 - 0.25 mL of distilled water, twice a day by oral gavage, group III included rats which underwent cerebral ischemia and then received DMF (15 mg/kg, twice daily, for 1 week) by oral gavage. Morris water maze test was used to assess spatial memory. Nitric oxide (NO) level in the hippocampus was measured using Griess test.
ResultsTreatment of rats with DMF (15 mg/kg, orally, twice daily for 7 days) resulted in a significant decrease in escape latency during training trials. Besides, the time spent in the target quadrant and the number of crossings over the platform area were significantly increased in the DMF-treated rats which were accompanied by a decrease in the proximity to the platform in the probe trial. Furthermore, the results of the Griess assay indicated a significant reduction in the NO levels in the hippocampus of DMF-treated rats.
ConclusionsOverall, our findings indicate that DMF improves memory impairment induced by cerebral ischemia/reperfusion injury in rats through the suppression of nitrosative stress in the hippocampus.
Keywords: Dimethyl Fumarate, Cerebral Ischemia, Memory Deficit, Nitric Oxide -
Background
Multiple sclerosis (MS) is a neurologic disorder with a considerable global burden. During the last decades, some pharmaceutical treatments have been approved for patients with MS. Dimethyl fumarate (DMF) is one of these drugs which has been reported to have early promising results in recent studies, but the efficacy of this drug in patients with MS is still being studied in different parts of the world. In the present study, we evaluated the effectiveness of DMF therapy on reducing relapses, lesions, and disability in Iranian patients with MS.
MethodsThe present single-arm before-after study was approved by the Ethics Committee of Mashhad University of Medical Sciences, Mashhad, Iran [Iranian Registry of Clinical Trial (IRCT) code: IRCT20190121042439N1]. Every patient who was diagnosed with relapsing MS was considered eligible to enroll in the present clinical trial. Before receiving DMF therapy, the baseline liver function tests and complete blood count were obtained from all individuals. Also, a baseline brain magnetic resonance imaging (MRI) was obtained and Expanded Disability Status Scale (EDSS) was documented from all patients. After receiving 240 mg DMF twice daily for 12 months, the laboratory and imaging measurements as well as EDSS were repeated. Furthermore, the total number of relapses within the study period was recorded. Satisfaction with DMF treatment was determined by answering a yes-no question.
ResultsA total number of 50 patients enrolled in the study and most of them were female (80%). There was a significant decrease in EDSS score and gadolinium (GD)-enhancing lesions after the study period (P < 0.001 for each). Moreover, the attacks significantly dropped after the study period (P < 0.001) and 86% of patients were satisfied with their treatment.
ConclusionThe findings of this study showed that 240 mg DMF administered twice daily can effectively reduce disability and provide satisfaction within the first year of therapy in patients with MS.
Keywords: Multiple Sclerosis, Magnetic Resonance Imaging, Dimethyl Fumarate -
Background
There is evidence that supports the neuroprotective effects of dimethyl fumarate (DMF) in stroke. Nuclear factor erythroid 2-related factor 2 (Nrf2) has both anti-oxidant and anti-inflammatory mechanisms. We investigated the neuroprotective effects of DMF via Nrf2 activation in the cortex, striatum, and diencephalon in a middle cerebral artery occlusion (MCAO) model of stroke.
Methods22 Sprague-Dawley male rats were randomized into 3 groups. In DMF-treated group (n = 8), rats received 15 mg/kg oral DMF twice daily by gavage from day 0 to 14 after a 60-minute MCAO. The vehicle group (n = 7) underwent MCAO and were given methocel/H2O, using the same method and schedule. In the sham group (n = 7), neck was opened, but neither middle cerebral artery (MCA) was occluded nor any drug was administered. After 14 days, the animals were sacrificed. The infarct volume were assessed by stereology method. Nrf2 expression was evaluated in the cortex, striatum, and diencephalon by immunohistochemistry method.
ResultsRatio of infarct to total brain volume was significantly lower in the DMF-treated group (5.76%) in comparison with the vehicle group (22.39%) (P < 0.0001). Nrf2 expression was higher in DMF-treated group in comparison with both the vehicle and sham groups in cortex, striatum, diencephalon, and total brain (P < 0.0001). In the DMF-treated group, significant negative correlation between Nrf2 expression and infarct volume was observed in cortex, striatum, diencephalon, and total brain.
ConclusionDMF induces Nrf2 expression and its neuroprotective effects in different brain anatomical regions.
Keywords: Stroke, Dimethyl Fumarate, Middle Cerebral Artery, Nuclear Factor Erythroid 2-Related Factor 2 -
Glioblastoma multiforme (GBM), the most frequent malignant and aggressive primary brain tumor, is characterized by genetically unstable heterogeneous cells, diffused growth pattern, microvascular proliferation, and resistance to chemotherapy. Extensive investigations are being carried out to identify the molecular origin of resistance to chemo- and radio-therapy in GBM and find novel targets for therapy to improve overall survival rate. Dimethyl fumarate (DMF) has been shown to be a safe drug with limited short and long-term side effects, and fumaric acid esters (FAEs), including DMF, present both anti-oxidative and anti-inflammatory activity in different cell types and tissues. DMF has also anti-tumoral and neuroprotective effects and so it could be repurposed in the treatment of this invasive tumor in the future. Here, we have reviewed DMF pharmacokinetics and different mechanisms by which DMF could have therapeutic effects on GBM.
Keywords: Brain Neoplasms, Glioblastoma, Fumarates, Dimethyl Fumarate, Neuroprotective Agents, Drug Repurposing -
PurposeThe objective of this study was to synthesize and statistically optimize dimethyl fumarate (DMF) loaded solid lipid nanoparticles (SLNs) for better management of multiple sclerosis (MS).MethodsSLNs were formulated by hot emulsion, ultrasonication method and optimized with response surface methodology (RSM). A three factor and three level box-behnken design was used to demonstrate the role of polynomial quadratic equation and contour plots in predicting the effect of independent variables on dependent responses that were particle size and % entrapment efficiency (%EE).ResultsThe results were analyzed by analysis of variance (ANOVA) to evaluate the significant differences between the independent variables. The optimized SLNs were characterized and found to have an average particle size of 300 nm, zeta potential value of -34.89 mv and polydispersity index valueConclusionThis study showed that the present formulation with improved characteristics can be a promising formulation with a longer half-life for the better management of MS.Keywords: Box-behnken design, Dimethyl Fumarate, Multiple Sclerosis, Response Surface Method, Solid lipid nanoparticles, Polydispersity index
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