Medicines
Discover all available medicines and treatments
Discover all available medicines and treatments
Brand: Tecfidera
Monomethyl fumarate (MMF) is the primary metabolite of dimethyl fumarate (DMF) and is considered the active moiety responsible for the therapeutic effects of DMF. It is classified as an immunomodulator and is primarily used in the treatment of relapsing-remitting multiple sclerosis (RRMS). MMF is believed to exert its effects through activation of the nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathway, which leads to antioxidant and anti-inflammatory responses within the central nervous system. It also appears to impact immune cell function, shifting the balance from pro-inflammatory to anti-inflammatory responses.
Used to treat relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.
This drug carries a boxed warning for the risk of progressive multifocal leukoencephalopathy (PML), a rare and serious brain infection that can result in death or severe disability. PML has occurred in patients treated with MMF. Before starting treatment, patients should have a baseline MRI. During treatment, patients should be monitored for any new or worsening neurological signs or symptoms that may suggest PML. If PML is suspected, MMF should be discontinued and appropriate diagnostic evaluation should be performed.
Outcome:
Reduced vaccine efficacy, increased risk of infection
Mechanism:
MMF's immunosuppressive effects can interfere with the immune response to live vaccines.
Outcome:
Increased flushing and gastrointestinal discomfort
Mechanism:
Possible additive vasodilatory effects.
Outcome:
May increase bioavailability of MMF.
Mechanism:
Enhanced absorption with food intake.
Most likely new formulation: Extended-release formulation (2025, 80% confidence)
Based on current usage trends and ongoing clinical trials, there is a 70% likelihood of expanded indications for MMF in other neurological conditions by 2027.
Immunomodulator, Nrf2 Activator
Fumaric acid ester