Dr. Jain is a consultant in neurology and has no relevant financial relationships to disclose.)
Historical note and terminology
Dimethyl fumarate, the methyl ester of fumaric acid, is also known by its chemical name, dimethyl (E) butenedioate, (C6H8O). It was initially used as a fungicide to prevent the growth of mold on furniture. Due to allergic skin reactions, this application was banned in Europe in 1988. Dimethyl fumarate was discovered to be effective as treatment for psoriasis in 1959 in Germany. Fumaderm®, a proprietary formulation of fumaric acid in combination with 3 other esters, is approved in Europe as an oral therapy for psoriasis. In 2013, the FDA approved dimethyl fumarate as a first-line oral treatment for relapsing forms of multiple sclerosis. Approval was granted by the European Commission in 2014. Diroximel fumarate is a novel oral fumarate approved in 2019 for the treatment of patients with relapsing multiple sclerosis, and it undergoes esterase cleavage to monomethyl fumarate, the same pharmacologically active metabolite as the previously approved delayed-release formulation of dimethyl fumarate.
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