Evidence map›Paper›PMID 39570545›Full record

Trial reportAdvances in therapy2025

Real-World Safety and Effectiveness of Dimethyl Fumarate in Patients with MS: Results from the ESTEEM Phase 4 and PROCLAIM Phase 3 Studies with a Focus on Older Patients.

Yang Mao-Draayer, Amit Bar-Or, Konstantin Balashov, John Foley, Kyle Smoot, Erin E Longbrake, Derrick Robertson, Jason P Mendoza, James B Lewin, Nicholas Everage and 5 more

2 registry-linked trialsAbstract readClinical Trial, Phase IIIClinical Trial, Phase IVMulticenter Study
In one paragraph

Trial report in Advances in therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02047097 completednot on this map

A Multicenter, Global, Observational Study to Collect Information on Safety and to Document the Drug Utilization of Tecfidera™ (Dimethyl Fumarate) When Used in Routine Medical Practice in the Treatment of Multiple Sclerosis (ESTEEM)

Typeobservational_patient_registrySponsorBiogenRan2013 to 2022Enrolled5,487ConditionsMultiple SclerosisArmsdimethyl fumarate
NCT02525874 phase3completednot on this map

An Open-Label Study to Assess the Effects of BG00012 on Lymphocyte Subsets in Subjects With Relapsing-Remitting Multiple Sclerosis

TypeinterventionalSponsorBiogenRan2015 to 2018Enrolled218ConditionsMultiple Sclerosis, Relapsing-Remitting, Multiple SclerosisArmsdimethyl fumarate
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Yang Mao-DraayerOklahoma Medical Research Foundation, Oklahoma City, OK, USA.ORCID 0000-0001-6248-3480
Amit Bar-OrPerelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.ORCID 0000-0001-7179-0335
Konstantin BalashovBoston University School of Medicine, Boston, MA, USA.ORCID 0000-0003-3409-8731
John FoleyRocky Mountain Multiple Sclerosis Clinic, Salt Lake City, UT, USA.
Kyle SmootProvidence MS Center, Providence Brain and Spine Institute, Portland, OR, USA.
Erin E LongbrakeYale University, New Haven, CT, USA.ORCID 0000-0002-1179-3937
Derrick RobertsonUniversity of South Florida College of Medicine, Tampa, FL, USA.ORCID 0000-0001-8993-0981
Jason P MendozaBiogen, Cambridge, MA, USA.ORCID 0000-0003-2526-5542
James B LewinBiogen, Cambridge, MA, USA. Jim.lewin@biogen.com.ORCID 0000-0002-2352-9113
Nicholas EverageBiogen, Cambridge, MA, USA.ORCID 0000-0001-7216-7836
Ivan BožinBiogen, Baar, Switzerland.ORCID 0009-0008-2205-4233
Jennifer LyonsBiogen, Cambridge, MA, USA.
Oksana MokliatchoukBiogen, Cambridge, MA, USA.
Eris BameBiogen, Cambridge, MA, USA.ORCID 0009-0007-6289-0562
Fabrizio GiulianiUniversity of Alberta, Edmonton, AB, Canada.

Funding

Institutional Career Development CoreKL2TR001862 · NCATS · YALE UNIVERSITY · PI CANTLEY, LLOYD G, EDELMAN, E. JENNIFER · 2016 to 2025
$12.2M
CD24 Targeting for Multiple Sclerosis: a First-In-Human Phase I StudyR01NS080821 · NINDS · ONCOIMMUNE, INC. · PI LIU, YANG · 2013 to 2014
$1.1M
University of Michigan Autoimmunity Center of Excellence, Clinical Research ProgrUM1AI110557 · NIAID · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI FOX, DAVID ALAN · 2014 to 2018
$543k
NCATS NIH HHS KL2 TR001862NIAID NIH HHS UM1 AI110557NINDS NIH HHS R01 NS080821
6 · The paper itself

Abstract

introductionReal-world studies in the USA report that 41-56% of patients with multiple sclerosis (MS) are ≥ 50 years old, yet data on their response to disease-modifying therapies (DMTs) is limited. Dimethyl fumarate (DMF) is an oral DMT approved for treating relapsing MS. This analysis evaluated the safety, efficacy, and immunophenotype changes of DMF in patients ≥ 50 years compared with patients < 50 years.

methodsESTEEM, a 5-year, real-world, observational phase 4 study, assessed the safety and effectiveness of DMF, including treatment-emergent serious adverse events (SAEs) and adverse events (AEs) leading to treatment discontinuation. Absolute lymphocyte counts (ALCs) were recorded from a subset of patients. The PROCLAIM study, a phase 3b interventional study, reported safety outcomes and lymphocyte subset changes in patients with relapsing-remitting MS (RRMS) treated with DMF. The study evaluated safety outcomes by analyzing the incidence of SAEs and detailed changes in CD4

resultsESTEEM included 4020 patients aged < 50 years and 1069 aged ≥ 50 years. AEs leading to discontinuation were reported by 19.6% patients < 50 years and 29.6% of patients ≥ 50 years, with gastrointestinal disorders being the most common. SAEs were reported by 5.2% of patients < 50 years and 8.9% those ≥ 50 years. In PROCLAIM, SAEs were reported in 13% of patients < 50 years and 10% of those ≥ 50 years. Median ALC decreased by 35% in patients < 50 years and 50% in those ≥ 50 years in ESTEEM, with similar patterns observed in PROCLAIM.

conclusionsESTEEM found no unexpected safety signals in older patients and annualized relapse rates (ARRs) were significantly reduced in both age groups. Both studies indicated that DMF is efficacious and has a favorable safety profile in patients with RRMS aged ≥ 50 years. CLINICAL

trial registrationESTEEM (NCT02047097), PROCLAIM (NCT02525874).

Indexed as

Dimethyl FumarateImmunosuppressive AgentsMultiple Sclerosis, Relapsing-RemittingAdultAgedAge FactorsFemaleHumansMaleMiddle AgedTreatment OutcomeDimethyl FumarateImmunosuppressive AgentsDimethyl fumarateEffectivenessReal-world evidenceRelapsing multiple sclerosisSafety

Identifiers

PMID39570545
PMCPMC11782338

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.