DMF: the Canadian MS patient experience


A majority of MS patients currently treated with dimethyl fumarate (DMF) state that their therapy is as easily tolerated as other disease-modifying therapies, according to the results of a recent online survey. The survey was conducted in December 2017-February 2018 on MSology, the sister site of NeuroSens. MSology provides news and resources to MS patients, and attracts about 35,000 visitors per year (

The 21-item survey asked patients currently treated with DMF about their experiences with the drug. All of the Canadian respondents (n=48) were current or recent DMF users. A majority of respondents were female (96%), aged 41 years or older (81%). Forty-percent were previously untreated, and 60% had been on a prior injectable DMT. Most had been taking DMF for 2-5 years (73%).  Self-rated wellness was Excellent (10%), Very good (42%), Adequate (35%), and as Poor/Very bad (13%).

DMF was chosen for efficacy reasons (46%), primarily because of prior treatment failure or physician choice. One-third said DMF was preferred because it is an oral drug and more convenient than an injectable.

A majority selected flushing both as the side effect that was the easiest to tolerate and the most difficult to tolerate. Flushing was also the most common dislike cited in the write-in section (31%). Other adverse events were less frequently mentioned, including gastrointestinal effects (8%), concerns about PML (4%), and itching (4%). Measures used to minimize adverse effects were to take DMF with food (85%), and to take low-dose ASA before dosing (42%). A total of 66% of respondents reported that they did not require non-prescription stomach remedies, such as bismuth subsalicylate or an H2 blocker.

When asked to compare the side effect burden with DMF compared to injectable DMTs, 53% said the burden was less with DMF, 34% said it was about the same, and 13% said it was worse with DMF.

A limitation of the survey was that respondents were self-selected DMF users. Prior MSology surveys have found that a majority of DMT-treated patients believe that their current therapy is the best treatment option.

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