Dimethyl Fumarate Dose Reduction in Lymphopenic Relapsing Remitting Multiple Sclerosis Patients: Clinical and MRI Outcomes

Objective: Utilize clinical measures to determine the outcome of dimethyl fumarate (DMF) dose reduction. Background: Dimethyl fumarate is a first-line therapy for treatment of relapsing and remitting multiple sclerosis (RRMS). DMF 240 mg twice daily can result in lymphopenia. Dose reduction may lessen the degree of lymphopenia, but clinical effectiveness of reduced dose DMF is unknown. Design/Methods: We performed a retrospective review of RRMS patients on oral DMF therapy from the University of Utah and Veterans Affairs Salt Lake City Health Care System databases (March 2013 to September 2018). Patients on reduced dose DMF due to lymphopenia were identified and included in this analysis Results: Of 425 patients identified through chart review, total of 92 patients had lymphopenia ( Conclusions: Our findings indicate that reduced dose DMF can result in improvement in lymphopenia as well as continued clinical stability over an intermediate time period. Consistent MRI monitoring for disease activity may be particularly important in these patients. Disclosure: Dr. Wong has nothing to disclose. Dr. Bacharach has nothing to disclose. Dr. Marini has nothing to disclose. Dr. Nguyen has nothing to disclose. Dr. Clardy has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Adivo Associates (