Evidence map›Paper›PMID 42060157›Full record

ArticleAdvances in therapy2026

Comparative Effectiveness of Diroximel Fumarate vs. Dimethyl Fumarate in Persons with Multiple Sclerosis: A US Claims Analysis of Relapse Outcomes.

Daniel Bandari, Devon Conway, Liang Dong, Nicholas Hong, Minxing Li, Anne Littlewood, Mike Roy, Sam Ulin, Chencan Zou, Babak Amerian-Williams and 4 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Advances in therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Daniel BandariMultiple Sclerosis Center of California, Laguna Hills, CA, USA.
Devon ConwayCleveland Clinic, Cleveland, OH, USA.ORCID http://orcid.org/0000-0001-5359-6686
Liang DongClearView Healthcare Partners, Newton, MA, USA.ORCID http://orcid.org/0009-0004-5300-4547
Nicholas HongClearView Healthcare Partners, Newton, MA, USA.ORCID http://orcid.org/0009-0008-6004-3690
Minxing LiClearView Healthcare Partners, Newton, MA, USA.ORCID http://orcid.org/0009-0000-5828-9458
Anne LittlewoodClearView Healthcare Partners, Newton, MA, USA.ORCID http://orcid.org/0009-0007-9357-8993
Mike RoyClearView Healthcare Partners, Newton, MA, USA.ORCID http://orcid.org/0000-0001-6675-660X
Sam UlinClearView Healthcare Partners, Newton, MA, USA.ORCID http://orcid.org/0000-0002-8729-0869
Chencan ZouClearView Healthcare Partners, Newton, MA, USA.
Babak Amerian-WilliamsBiogen, Cambridge, MA, 02142, USA.ORCID http://orcid.org/0009-0007-5117-9871
Nicholas BelvisoBiogen, Cambridge, MA, 02142, USA.
James B LewinBiogen, Cambridge, MA, 02142, USA. jim.lewin@biogen.com.ORCID http://orcid.org/0000-0002-2352-9113
Jason P MendozaBiogen, Cambridge, MA, 02142, USA.ORCID http://orcid.org/0000-0003-2526-5542
Mirla AvilaComprehensive MS Center, Texas Tech University, Lubbock, TX, USA.ORCID http://orcid.org/0000-0003-0605-9559

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDiroximel fumarate (DRF) and dimethyl fumarate (DMF) are established disease-modifying therapies for relapsing multiple sclerosis (RMS). While DRF has demonstrated improved gastrointestinal tolerability compared to DMF, there is limited research evaluating whether this difference in tolerability translates into a difference in clinical effectiveness. This study evaluated the real-world effectiveness of DRF versus DMF on relapse outcomes in persons with MS (pwMS) in a large US population.

methodsThis retrospective cohort study utilized the Forian administrative claims database (January 1, 2018-June 30, 2025). Adult pwMS initiating DRF or DMF were identified and propensity score-matched (1:3 ratio) based on baseline demographic and clinical characteristics. Endpoints were assessed over 1- and 2-year follow-up periods. The primary endpoint was annualized relapse rate (ARR).

resultsThe 1-year analysis included 1780 DRF-treated and 5340 DMF-treated pwMS; the 2-year analysis included 739 DRF-treated and 2217 DMF-treated pwMS. At 1 year of treatment, DRF was associated with a significantly lower ARR compared to DMF (0.12 vs. 0.16; p = 0.03), representing a 21% reduction in relapse rate (rate ratio 0.79; 95% CI 0.64-0.97). At 2 years of treatment, DRF maintained a lower ARR compared to DMF (0.11 vs. 0.16; p = 0.02), reflecting a 31% reduction in relapse rate (rate ratio 0.69; 95% CI 0.54-0.87).

conclusionThe results of this real-world analysis indicate DRF may be more effective than DMF in reducing relapses over 1 and 2 years of treatment in pwMS.

Indexed as

Dimethyl FumarateImmunosuppressive AgentsMultiple Sclerosis, Relapsing-RemittingAdultFemaleFumaratesHumansMaleMiddle AgedRecurrenceRetrospective StudiesTreatment OutcomeUnited StatesDimethyl Fumaratediroximel fumarateFumaratesImmunosuppressive AgentsAdherenceComparative effectivenessDimethyl fumarateDiroximel fumarateMultiple sclerosisReal-world evidenceRelapseVumerity

Identifiers

PMID42060157
PMCPMC13290777

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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.