Here's a snapshot from a recently published clinical commentary about dimethylfumarate (dmf or brandname Tecfidera) and prolonged lymphopaenia (low total lymphocyte count) that I pinched from a neurologist's Twitter feed this morning. Fact: neurologists tweet, friends and family do Facebook; meanwhile clubs, charities and anyone wanting to sell you something do both!
Anyway, what the report points out is that dmf causes marked lymphopaenia that persists after drug discontinued. Like me, this patient had switched to dmf after beta interferon and, also like me, only took dmf for four months. Clearly, dmf lymphopaenia has no bearing on how effective the drug is as this patient had a severe relapse despite her lymphopaenia. I know from my own experience that two years post dmf short course total lymphocytes remain low and from the flow cytometry (measuring lymphocyte subsets) the cell group particularly low are the CD8 T cells. Dmf must deplete memory B cells to a moderate extent whist being taken for it to be moderately effective. It would seem to me that at the expense of long term lymphopaenia in particular low CD8 count this drug is not worth the risk.
Sorry folks, next post will have some photos..... here's a clue #tandem #christmas #fancydress
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